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Expanded Skilled Nursing Facility Medicare Coverage During the Covid-19 Pandemic

The COVID-19 pandemic has been particularly devastating for nursing homes and their residents. Aside from the tragically disproportionate loss of life, care for surviving residents has been delayed or interrupted due to infection, facility lockdowns, or other health system disruptions. As a result, the Centers for Medicare & Medicaid Services (CMS) has waived two limitations on Medicare Part A skilled nursing facility (SNF) coverage during the coronavirus pandemic: The 3-day qualifying hospital stay requirement; and The 100-day benefit period.  However, CMS treats the two SNF coverage expansions differently from [...]

By |2021-03-04T08:21:58-05:00March 4th, 2021|Aging, Assisted Living, Blog, Elder Care, Medicaid, Medicare, Nursing Home|

Elder Law Planning: More Than Just Medicaid

When it comes to elder law planning, and when I meet with clients, the focus tends to be heavily centered on finances. When retirement accounts are dwindling due to a spouse’s high nursing home bill or a parent’s complex financial management style has left an adult child overwhelmed and confused, it is easy to become focused on Medicaid as the magic solution. However, Medicaid is just one piece of a much larger puzzle. A few years ago, I worked with the sister caregiver of a client who required long-term [...]

By |2021-02-25T08:19:00-05:00February 15th, 2021|Aging, Blog, Elder Care, Health Law, Medicaid|

Effect of Stimulus Payments on Medicaid Eligibility

In light of the recent $600 stimulus bill payments, as well as the potential for up to $1,400 more to be paid to all eligible individuals over the next few months, we wanted to update you regarding the effect of the stimulus payments on Medicaid eligibility.  Additionally, as well as an update on the long-term care communities’ responsibilities regarding the payments for residents. In May 2020, the NJ Division of Medical and Health Services (DMAHS) advised that an individual, including a nursing home resident, can make cash gifts to [...]

By |2021-02-02T17:08:56-05:00January 29th, 2021|Assisted Living, Blog, Medicaid|

Your Public Benefits Have a Lookback – Even Around the Holidays!

The holiday season is upon us yet again. It is easy to get caught up in the festivities and forget that if you or a loved one are enrolled in a public benefits program or are planning to apply in the future, it is important to remember that even holiday gifting can impact eligibility. Are you or your spouse receiving Medicaid benefits? Or will you need long-term care in the next five years? If so, a review of five years’ worth of all financial documents is conducted during the [...]

By |2020-12-10T08:54:12-05:00December 10th, 2020|Blog, Health Law, Medicaid|

Reviewing Your Health Insurance During Medicare Open Enrollment

As Fall approaches, everyone looks forward to the crisp weather, pumpkin spice and Halloween, but here at Rothkoff Law Group, it also means preparing for the Medicare open enrollment period. Open enrollment in 2020 will run October 15, 2020 through December 7, 2020. Any changes made during this time will take effect for 2021. While many may ultimately not need to make any changes at all, it is a good reminder to assess your needs for the upcoming year. During open enrollment, you can make the following changes: Change [...]

By |2020-08-31T09:49:27-04:00August 31st, 2020|Blog, Medicaid, Medicare|

Does Medicare Pay for Nursing Home Care?

Many people are under the misperception that Medicare will pay for nursing home care. Medicare, the federally funded health insurance received upon attaining 65 years of age, will only pay for skilled nursing care under certain circumstances and then only for a limited period of time. When you have been discharged from a hospital stay of at least three days to a Medicare-approved skilled nursing facility, and if you require “skilled” care for treatment of the condition for which you were hospitalized, Medicare will pay 100% of the cost [...]

By |2020-07-28T10:57:44-04:00July 28th, 2020|Blog, Medicaid, Medicare, Nursing Home|

Making the Medicaid Application Process Easier

The Medicaid application process is notoriously overwhelming and beginning to gather the information that will be required can be daunting. Whether applying for Medicaid in Pennsylvania or New Jersey, the caseworker assigned to the file will request to review five years’ worth of bank statements with accompanying documentation. This requirement, known as the “five-year lookback”, is unavoidable and can be an intimidating roadblock. As Public Benefits Coordinator for Rothkoff Law Group, I have been assisting clients with the Medicaid process for almost six years. Below are three tips for [...]

By |2020-08-21T10:27:52-04:00July 21st, 2020|Blog, Medicaid|

Coronavirus Stimulus Checks: Everything you need to know to receive the funds

The first wave of coronavirus stimulus payments of up to $1,200 apiece are on their way, arriving in bank accounts through set up direct deposit with the IRS.  Up to 150 million US residents may qualify for a payment. If you haven't yet received your one-time payment and haven't set up electronic funds transfer with the government, setting up direct deposit may help you get your money faster. Otherwise, you can expect a paper check in the mail. Is the money yours, free and clear? Yes. You don't have [...]

By |2020-08-21T11:30:30-04:00April 20th, 2020|Aging, Blog, Law Update, Medicaid|

Update on COVID-19 Related Policy Changes or Medicare Changes

Under the CARES Act signed into law on March 27, the Medicare related provisions of the bill include: Significant expansion of telehealth services that can substitute for certain visits that usually require in-person visits with health care providers, such as remote patient monitoring for home health services, hospice recertification, and nephrologist visits for those using home dialysis; Allowing physician assistants, nurse practitioners, and other professionals to order home health services for beneficiaries; Waiving the Inpatient Rehabilitation Facility (IRF) 3-hour rule, which requires that a beneficiary be expected to participate [...]

By |2020-08-21T11:43:54-04:00April 6th, 2020|Blog, Medicaid|

Reflections on the 6th Annual National Voices of Medicare Summit and Senator Jay Rockefeller Lecture

On May 9, 2019, members of the Rothkoff Law team including Jerry Rothkoff, Bryan Adler, Roxanne Crowley, Kaitlin Dirxx, and Chelsea Ganssle traveled to Washington, DC to attend the Center for Medicare Advocacy’s sixth annual National Voices of Medicare Summit and Senator Jay Rockefeller Lecture at the Kaiser Family Foundation.  The theme of the day was Health Care as a Human Right: Medicare’s Role in Making it a Reality. The Summit convened advocates, leading experts, and policy-makers to discuss access to quality health care for all, the challenges and [...]

By |2020-08-24T10:59:09-04:00May 20th, 2019|Blog, Medicaid, Medicare|

2019 Elder Law Numbers

The Centers for Medicare and Medicaid Services (CMS) has released the new Medicare premiums, deductibles, and co-payments for 2019:• Basic Part B premium: $135.50/month (was $134.00 in 2018)• Part B deductible: $185 ($183.00 in 2018)• Part A deductible: $1,364 (was $1,340 in 2018)• Co-payment for hospital stay days 61-90: $341/day (was $335 in 2018); Co-paymentfor hospital stay days 91-150: $682/day (was $670 in 2018)• All costs for each day beyond 150 days• Skilled nursing facility co-payment, days 21-100: $170.50/day (was $167.50 in 2018)Also, note that individuals with annual incomes [...]

By |2020-08-25T11:37:59-04:00December 31st, 2018|Blog, Medicaid, Medicare|

Protecting Nursing Homes and Their Residents

The nursing home admission process can be a daunting process for elders and their families. Unfortunately, some nursing homes are compounding the difficult process by referring residents and their families to non-attorney unlicensed Medicaid advisors. Non-lawyer Medicaid advisors can include financial advisors, geriatric care managers, disbarred attorneys, former nursing home employees, and a variety of other untrained and unlicensed individuals. The growing trend in the use of unlicensed, non-lawyer Medicaid advisors raises ethical and legal issues for both the Medicaid advisors and those who refer to such individuals. Should [...]

By |2020-08-25T11:50:48-04:00November 26th, 2018|Blog, Medicaid, Nursing Home|

Medicare to Implement Financial Penalties For Nursing Homes with High Hospital Readmission Rates Effective October 1, 2018

Modeled after a program that encourages low readmission rates to hospitals, the Centers for Medicare and Medicaid Services (CMS) will introduce a new financial incentive program effective October 1, 2018 for skilled nursing facilities. CMS will withhold 2% of a facility’s Medicare reimbursement until they have shown that they can keep down the number of their residents who return to a hospital within 30 days of discharge. What does this mean for nursing home residents?  In theory, the new regulations will improve nursing home discharge planning by making nursing [...]

By |2020-08-25T11:59:21-04:00October 1st, 2018|Blog, Medicaid, Medicare|

Medicare Advantage Plans Expanded Coverage of Health Related Benefits

Medicare Advantage Plans Expanded Coverage of Health Related Benefits – Does it Create Further Health Care Disparities? Last month, the Centers for Medicare & Medicaid Services (CMS) expanded how it defines the term “primarily health related” benefits that insurers are permitted to include in their private Medicare Advantage plans.  Insurers would include these extra health related benefits in addition to what traditional Medicare covers.  These benefits may include transportation to doctors, home modifications, better food options, or home care aides.  Of the 61 million people enrolled in Medicare, 20 [...]

By |2020-08-26T11:41:11-04:00May 7th, 2018|Blog, Medicaid|

10 Things to Know About Your New Medicare Card

Starting in April 2018 Medicare will begin mailing new cards out to those enrolled. In preparation, CMS (Center for Medicare and Medicaid Services) has outlined 10 things to know about your new Medicare card. Click here to see the full link or view the pdf below.      

By |2020-08-06T12:23:29-04:00February 16th, 2018|Blog, Medicaid, Medicare|
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