December 31, 2012
Dear Friend of the Firm:
We wish you and your families a happy and healthy New Year. I would like to take a few moments to reflect on the “year in elder law” and update you on our elder and disability law firm.
Some of the highlights from the world of elder law in 2012 include:
- Affordable Care Act upheld – On June 28, 2012, the US Supreme Court announced their decision on the Patient Protection and Affordable Care Act, upholding the vast majority of the law that was originally passed in 2012.
- New Jersey Comprehensive Waiver – The Centers for Medicare and Medicaid Services (CMS) approved New Jersey’s request to revise its home and community based Medicaid Waiver program. Among other revisions, New Jersey’s Medicaid income cap will be removed to allow additional residents to be eligible for home and community based Medicaid programs.
- Medicare Changes Improvement Standard – For many Medicare beneficiaries receiving skilled services in a nursing home, outpatient setting, or through home health services, they often get cut off too early. Providers were ending services because the client was not showing any progress. Following a lawsuit filed in 2011, Medicare will be changing its rules to read that as long as the skilled services are necessary to maintain functioning, the beneficiary can keep receiving those skilled services regardless of whether the beneficiary is showing any improvement or progress. The changes should allow patients to receive more therapy. There will still be caps and limits to services will be in place (e.g., there is a 100-day/benefit period to receiving rehab services in a skilled nursing facility that will not change).
- The Donut Hole is Closing -By 2020, the coverage gap in Medicare Prescription Drug Coverage, or Part D, will be eliminated. In 2012, however, beneficiaries received a 50% rebate on brand name drugs and a 14% rebate on generic drugs while they were in the donut hole. Beneficiaries will continue to spend less, and drug companies will offer more discounts until the coverage gap is closed.
- Medicare Reduced Payments to Hospitals With High Readmission Rates – Starting on October 1, 2012, hospitals that have a high rate of readmissions within 30 days of discharge of certain Medicare beneficiaries (those with COPD, heart attack, or pneumonia diagnoses) began seeing their total Medicare reimbursements reduced. The Center for Medicare and Medicaid Services (CMS) began a new program to encourage hospitals to do all they can to keep beneficiaries from needing to come back to the hospital. This program was created when CMS realized that almost one in five Medicare beneficiaries were being readmitted back to the hospital within 30 days of leaving. This new program has motivated some hospital to create robust care transition programs and to work more closely with community partners to get more services for their patients.
From a firm perspective, we continue with our goal of attempting to have the best staff possible to help our clients and families navigate the long-term care planning puzzle. To that end, in January 2012, we were excited to welcome David Goldwasser to our office as our Health Insurance Advocate. David brings over ten years of experience in health insurance advocacy and coordination. David previously served as the State Health Insurance Assistance Program (SHIP) Director for Camden County.
In February 2012, we were delighted to welcome the addition of Alicia Kagan as our Public Benefits Specialist. Alicia brings to us a wealth of experience in Medicaid and long-term care planning based upon her extensive experience at the Camden County Office of Aging.
In October 2012, Jennifer Cooley joined our team as a Geriatric Care Coordinator. Jennifer brings over ten years of extensive experience in advocacy for seniors and their families. Most recently, as a Senior Services Specialist at a New Jersey Continuing Care Retirement Community. Jennifer’s experience as a Care Manager with the Philadelphia Corporation For Aging developed her expertise in home environment assessments and strengthened her knowledge of Pennsylvania’s program offerings for seniors.
On a personal note, in September 2013, I was honored to be elected President of the Life Care Planning Law Firm Association (LCPLFA). Janie Deleon Male, our Director of Care Coordination, was elected to the LCPLFA Board of Directors.
Rothkoff Law Group served over 300 clients in 2012. This includes helping over 50 clients access the Veterans Aid and Attendance Benefits, assisting over 75 clients plan for Medicaid as part of their long-term care, and advocating for over 150 clients to ensure quality care in a community or long-term care setting.
We could not have done this without the assistance of our knowledgeable and dedicated team. I am very proud of the law firm staff we have assembled to assist our clients and their families. It is privilege and a pleasure to work with each of them.
Please feel free to visit our newly revised website, www.rothkofflaw.com, for updated information on elder law news, as well as our seminar schedules and speaking engagements for 2013.
None of us truly know what is in store for 2013. There are still many issues facing our country as a whole: an economy that is not rapidly growing, issues with the fiscal cliff and continued growth of the population over sixty-five. There will no doubt be continued changes in our healthcare system in the way that services are delivered and paid for. This is certainly a challenging time and there still appears to be no adequate or new solutions for taking care of our population that is dealing with chronic care issues.
We are always attempting to improve the services we offer. The success of our firm is a direct reflection of our clients and the referral sources that have supported us. Therefore, we actively welcome your referrals and encourage you to contact our office should you have any suggestions, questions or concerns regarding yourself or a loved one. On behalf of our entire office team, we wish you and your families a very prosperous and healthy 2013.
Jerold E. Rothkoff