As individuals begin to age, long-term care services and how to finance them become major concerns. Many turn to Medicaid to pay for their long-term care needs. Medicaid is a joint Federal and State funded program that provides medical insurance and long-term care payments on behalf of middle- to low-income individuals, including those who are elderly and disabled. However, since Medicaid eligibility is determined by the combined value of income and assets, gifting money and joint accounts may impede a person’s ability to secure Medicaid benefits.
There are several types of Medicaid fraud, such as those who receive Medicaid fraudulently. Medicaid recipient fraud may include an applicant falsifying information on the application and certification failure to disclose information about income and assets owned, and the failure to disclose income earned by a spouse or other household member. Other activities that can be deemed as fraud are loaning another person their Medicaid identification card, changing or creating a falsified order or prescription, using more than one Medicaid identification card, deliberately receiving excess, duplicative or conflicting medical service and/or supplies, and selling Medicaid-provided supplies to others.
A recent National Public Radio (NPR) investigation revealed that nearly 20 percent of senior nursing home residents receive some form of antipsychotic medications.
Similar reports, drawing from the NPR investigation, found significantly higher rates of antipsychotic drug usage concentrated in the Western New York area. In the Rochester region, data revealed that antipsychotic drug usage rates reached up to 30 percent.*
A recent exposé by the New York Times revealed that as nursing homes revamp their facilities to include luxury living quarters, the disparity between the lavish amenities of short term accommodations, and the quality of care can be drastic. Although nursing homes are attempting to lure in patients whose short stays will be funded by Medicare dollars, in lieu of Medicaid, many patients are being discharged from the facilities before they have been rehabilitated. Or worse yet- they leave with more medical issues than they had upon admittance.
A recent examination of federal data conducted by USA Today has recently revealed that the number of U.S. senior citizens receiving narcotic painkillers and anti-anxiety medications under Medicare’s prescription drug program is sharply rising. Recreational drug use can still be classified under medication-related problems (MRPs). Caregivers can play a key role in identifying and managing substance abuse issues, however, they may also be held liable if they fail to notice the signs of substance abuse.
Federal and State law provide a number of programs to help a person with disabilities. Such programs include. Security Income and Medicaid. Supplemental Security Income, or SSI, is a federal program that provides monthly cash payments to people in need. SSI is for individuals who are 65 or older, as well as for blind or disabled people of any age, including children.
While many things remain the same, the laws in the United States are constantly subject to change and revision. Elder law is no different. It is crucial to stay informed and understand the latest regulations that concern you or your loved ones. Below are a few changes made in 2014 regarding elder law (or laws that are particularly relevant for seniors and their families who are attempting to plan for the future):
We all expect and hope to have long and healthy lives. However, the truth is, no one lives forever and all too often health issues and accidents occur, leaving many individuals unprepared and in trouble. But there is something you can do to ensure you are never put in this position: PLAN! By planning ahead, you are able to answer the tough questions and make arrangements while you are in good health and mind.
The Office of the Medicaid Inspector General works to eliminate fraud by responding to allegations, doing specialized reviews of home health claims and inventory reports, while targeting providers who inappropriately bill Medicaid for services and patients who are provided services they aren’t entitled to receive.
While the main focus of Medicare has historically been to provide affordable and accessible medications to seniors, its focus has recently changed. Early this January, The U.S. Centers for Medicare and Medicaid Services (CMS) announced a proposed rule that would bring significant changes to the federal agencies.
The most notable change offered by the proposal is the agency’s new authority to kick out physicians and other providers who engage in abusive prescribing. It could also take such action if providers’ licenses have been suspended or revoked by state regulators or if they were restricted from prescribing painkillers and other controlled substances.
Additionally, the agency will tighten a loophole that has allowed doctors to prescribe to patients in the drug program (known as Part D) even when they were not officially enrolled with Medicare. Under the new rules, doctors and other providers must formally enroll if they want to write prescriptions to the 36 million people in Part D. This requires them to verify their credentials and disclose professional discipline and criminal history. Continue reading “Medicare Wants the Power to Ban Certain Doctors”