The Medicare Part B Trap of 2010

Merger of Department of Aging & Office of Long Term Living

Another Bill Seeks to Expand Estate Recovery

How to Choose an Elder Law Attorney

Marshall, Parker & Associates’ Third Annual Retreat a Success

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The Medicare Part B Trap of 2010

Written By: Attorney Jeffrey A. Marshall, CELA*

Social Security is probably not going to have a cost-of-living adjustment for beneficiaries in 2010 because the recession has been holding down the Consumer Price Index.  But while consumer prices may be steady, health-care costs continue to rise, and Medicare Part B premiums -- which are designed to cover about 25% of the total costs of Part B -- are expected to go up.

Does this mean that Medicare recipients will receive a smaller monthly Social Security payment next year?  Except for a possible small decrease due to Part D drug premiums, the answer for most seniors is “no.” Three quarters of Medicare beneficiaries will not have to pay any increased Part B premiums because of a "hold harmless" provision in the law. This provision prohibits Part B premiums from rising in any one year more than that year's cost of living increase in Social Security benefits

People who are covered by the hold-harmless provision will continue to pay Part B premiums of $96.40 per month in 2010. 

But this “hold harmless” protection does not apply to about one in four (or about 11 million) beneficiaries who:

    * do not have their Part B premiums withheld from their Social Security checks, or

    * pay a higher Part B premium surcharge based on high income, or

    * are newly enrolled in Part B.

Since 75% of Medicare beneficiaries are protected from a premium increase, the remaining 25% are going to have to bear the full brunt of the increase in Part B costs.  They are going to get hit by significantly higher Part B premiums next year unless Congress addresses this problem before then.

For example, if you reach age 65 in 2010 you most likely will become newly enrolled in Medicare.  Your Part B premium will be higher than $94.60 because of this quirk in the law. 

But, some seniors facing higher premiums may be able to get them reduced. 5% of Medicare recipients will be paying an extra Part B premium because they had high income in prior years.  The premium surcharge in 2010 will be based on their Modified Adjusted Gross Income (MAGI) as shown on their 2008 tax return. [In 2009 the surcharge applied to individuals who had a (MAGI) of more than $85,000 and to married couples with an income of $170,000 or more].

But what if your income has declined substantially since 2008 due to retirement or other factors?  If your income has declined since 2008 due to a “life changing event” you may be able to reduce or eliminate your high income surcharge. You need to file an appeal to get this surcharge reduced. 

"Life-changing events," include marriage, divorce, job loss, reduced work hours, loss of income from income-producing property or cuts in pension benefits. For example, if your income has dropped significantly since 2008 because you retired last year, this “life-changing event” may allow you to file for a reduction in your Part B premium surcharge.  Unfortunately, a decline in income due to changes in investment returns does not qualify as a life changing event. 

To contest your high income premium assessment you will need fill out Form "Medicare Part B Income-Related Premium-Life Changing Event," which you can find at www.ssa.gov/online/ssa-44.pdf. For more information on high income Part B premiums see the Social Security Administration website at http://www.ssa.gov/pubs/10161.html or call Social Security at 1-800-772-1213.

Attorney Marshall can be contacted at webmail@paelderlaw.com or at 1-800-401-4552. More information about Attorney Marshall is available on our website at www.paelderlaw.com/staff.html

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Merger of Department of Aging & Office of Long Term Living

Written By: Attorney Jeffrey A. Marshall, CELA*

The Rendell Administration has proposed legislation (HB 1152) that will integrate the Office of Long Term Living (OLTL) and the Department of Aging.  The bill seeks to establish a cabinet-level State agency that would combine the Department of Aging with OLTL. The new Agency would have some of the functions currently performed by the Department of Public Welfare (DPW) in regard to long-term living programs for people with disabilities and older adults. It would be in charge of the financing and administration of all long term living programs for disabled young and old alike regardless of whether services are provided in home and community based settings or in nursing facilities.

In theory the merger makes a lot of sense.  Consider the Aging Waiver.  One agency (DPW) is responsible for funding while another (Aging) is responsible for administration.  In fact, 52 separate Area Agencies on Aging are responsible for administration. The result is a system that many perceive as being terribly fragmented and inconsistent. Merger offers the potential to improve program administration by eliminating inefficiencies, establishing uniformity and improving communication. 

But there are some caution flags on the merger track.  This is a complicated reorganization that will take a lot of effort to implement. Will other important initiatives get lost while so much energy is directed to the merger? Aging, DPW and OLTL already have a tremendous amount on their plates.  Can they successfully implement a reorganization of this magnitude in the short time remaining for the Rendell Administration?  Or will this be an initiative that is promoted heavily without really getting off the ground?  

And what effect will the merger have on the Department of Aging? Aging was originally established to serve as an advocate for older adults.  Its founding legislation gave it the objective of “advancing the well being of Pennsylvania’s older citizens.” Will this fundamental mission be diluted by the merger? 

Will the merger cost Aging its local focus and control and lead to the regionalization of Pennsylvania’s area agencies on aging? Historically, our aging services network has had a local county based locus. Local administration was lauded as being consumer focused and more responsive than regional or state administration of services.  Now it appears that the perception, at least in Harrisburg, has shifted to viewing local administration as a cause of fragmentation, inefficiency, inconsistency, and local political influence.  The result is a trend toward regionalization.  The merger of OLTC and Aging may be part of this trend and may reduce the influence of local area agencies on aging. 

House Bill 1152 passed the State House on June 30^th by a vote of 110-84.  It now is in the hands of the Senate Aging and Youth Committee.  The Rendell Administration’s “Case for Change” is available at http://drnpa.org/File/caseforchange.pdf.

Attorney Marshall can be contacted at webmail@paelderlaw.com or at 1-800-401-4552. More information about Attorney Marshall is available on our website at www.paelderlaw.com/staff.html

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Another Bill Seeks to Expand Estate Recovery

Written By: Attorney Jeffrey A. Marshall, CELA*

July is always an interesting month in Pennsylvania as our annual budget battle gives birth to hastily considered new laws.  This year’s budget impasse is particularly dramatic. We need to find 3 billion dollars. 

One of the ways the Administration is seeking to raise a small amount of additional funds is by expanding estate recovery.  Estate recovery is a program that the state uses to seek repayment of Medicaid expenditures after the death of a nursing home resident or home care recipient.

In a prior Elder Care Law Alert, I wrote about Section 1412 of House Bill 1531, which would expand recovery to claim any assets in which an older Medicaid recipient had any interest at the time of death, including interests held through joint tenancy, tenancy by the entireties, life estate, living trust or other arrangement. This would mean, for example, that a home owned jointly with a community spouse would be subject to estate recovery. See “Budget Proposal Targets Homes of Seniors.” 

Unfortunately, in early June a second estate recovery proposal was introduced.  It was slipped in as a late amendment into an otherwise innocuous HB 68.  The general intent of HB 68 prior to the amendment was to increase the amount of funds a financial institution can release directly to family or a funeral director after the death of a depositor from $3,500 to $15,000.  

Section 2 of HB 68 [3101(b)(2)] was added as an amendment in June, just before the bill passed the House by unanimous vote. If the deceased depositor was over age 55, Section 2 mandates that the financial institutional turn the depositor’s small account of $15,000 or less over to DPW rather than the family. The only exceptions are for small payments of up to $3,500 to a funeral director or if the financial institution has received a letter from DPW stating that there is no estate recovery claim.

This bill’s enactment would mean that estate recovery would now impact small bank accounts owned by decedents who never applied for Medical Assistance. Most seniors never receive Medical Assistance.  And if they do, they generally can have no more than $2,400 in a bank account. But, transfer of the funds in the small account to DPW is required for any depositor who was over age 55 at the time of death, even if the decedent never applied for any benefits through DPW. 

Under Section 2, executors and family members will be denied access to funds needed to pay expenses after the death of a depositor.  They may have to seek eventual reimbursement from DPW.  It is hard to imagine the cost and added hardships that will result.  At the very least, Section 2 will result in delays and costs for banks, personal representatives, family members, funeral directors, creditors and even DPW.

 Frankly, I don’t know why DPW would even want to get involved in the mess that will be created.

HB 68 is now under consideration by the Pennsylvania Senate.  Voters might want to let their State Senator know that Section 2 of HB 68 is a bad idea. 

Attorney Marshall can be contacted at webmail@paelderlaw.com or at 1-800-401-4552. More information about Attorney Marshall is available on our website at www.paelderlaw.com/staff.html

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How To Choose An Elder Law Attorney

Written By: Attorney Jeffrey A. Marshall, CELA*

Many lawyers advertise that they practice “elder law.”  A few lawyers also state that they are “certified elder law attorneys.” What’s the difference? Does it matter to you?

Elder law is a distinct legal field which concentrates on the legal, financial, social and health care needs of people over age 50. Areas of the law that have been defined as core aspects of "elder law" include:

1.      Estate and Financial Planning, including preparing wills, trusts, and powers of attorney; deeds, and providing advice on the financial and tax implications of any proposed action.

2.      Medicaid and other Public Benefits Advice, including assisting clients to obtain Medicaid (Medical Assistance) and other benefits, and protecting assets from nursing home costs. Medicaid, the largest payment source of nursing home care, is one of the most complicated areas of the law.

3.      Administration of Estates.

4.      Health and Personal Care Planning, including advance medical directives.

5.      Income, Estate, and Gift Tax Advice, for limiting taxes, preserving financial security, and achieving other financial goals.

6.      Special Needs Planning for children and adults who need long term services and supports. 

Each of these areas is complex. For older Americans who don’t have the opportunity to “start over” mistakes can be particularly costly. Older consumers and their families need to work with a lawyer who is an expert in the ever-changing elder laws and understands the planning options and opportunities. 

To help consumers find a lawyer with these special skills, the Pennsylvania Supreme Court has established a elder law certification program for lawyers. Only lawyers who have met the Supreme Court's strict requirements for certification receive the designation as a Certified Elder Law Attorney (CELA). Achieving CELA status is the gold standard for a lawyer who practices elder law.

In order to earn the CELA designation, a lawyer must meet the following minimum qualifications:

∙       Practice Experience - Be licensed to practice law and be in good standing in all jurisdictions where licensed; have actively practiced law during all of the past 5 years.

∙       Substantial Involvement - Practiced elder law at least 800 hours in each of the past 3 years, handling at least 60 elder law matters in a specified distribution over 13 defined areas of elder law.

∙       Continuing Legal Education - Completed at least 45 hours of Continuing Legal Education in elder law during the past three years.

∙       Peer Review - Be recommended confidentially by at least 5 peers, at least 3 of whom practice elder law more than 800 hours per year.

∙       Examination - Complete a rigorous, all-day written examination in elder law.

∙       Re-certification - Undergo re-examination and re-certification every 5 years.

The examination is difficult.  It is intended to weed out lawyers who lack a high degree of expertise in elder law and special needs planning.  Only 27% of the lawyers who took the exam in the Spring of 2009 passed it. 

Families in need of elder law services need to understand that while any lawyer can say that they practice elder law, only a lawyer who has proven his or her knowledge by passing the proficiency examination can become a CELA.  Of the roughly 50,000 lawyers in Pennsylvania, only 37 have attained the status of CELA. Marshall, Parker & Associates are true specialists in elder law.  Each of our five attorneys has earned CELA status. 

Most consumers understand that there are real benefits to obtaining services from a certified specialist. It provides assurance that their lawyer has the skill, experience and judgment to provide older adults with the quality services they deserve. Seeing a certified specialist can mean extra peace of mind for the entire family.

When you or a family member or friend needs estate planning, long term care planning, or special needs planning, make sure they see an expert – make sure they consult with a Certified Elder Law Attorney (CELA). Visit the National Elder Law Foundation’s website at www.nelf.org for a list of CELAs and additional information on certification.

Attorney Marshall can be contacted at webmail@paelderlaw.com or at 1-800-401-4552. More information about Attorney Marshall is available on our website at www.paelderlaw.com/staff.html

 

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Marshall, Parker & Associates’ Third Annual Retreat a Success

Written By: Melissa Bottorf, Director of Marketing & Business Development

With four offices and over 20 employees, it’s not very often that the staff at Marshall, Parker & Associates has an opportunity to enjoy some time together.  That’s why each summer we close our offices for two days so everyone can attend our annual firm retreat. Each year we invite an expert facilitator to provide us with information, tips and tools that we can use to better serve our clients and improve our personal and professional lives. 

This year’s retreat facilitator was particularly outstanding.  Mitch Feld, of the M. Feld Group from Fort Lauderdale, FL spent months getting to know our firm, our philosophies, our mission and our staff.  He took everything he learned and customized a retreat to make our team an even more dedicated group of professionals than we were before. Of course, we participated in some fun activities, but by the end of the two days, each of us gained many valuable insights and came away with a renewed determination to make Marshall, Parker & Associates a truly amazing place to work.

Melissa can be contacted at webmail@paelderlaw.com or at 1-800-401-4552. More information about Melissa is available on our website at www.paelderlaw.com/staff.html 

Follow Marshall, Parker & Associates’ Managing Attorney

Jeff Marshall on twitter at:

www.twitter.com/ElderLawGuy 

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Contacting Marshall, Parker & Associates for Assistance

Marshall, Parker & Associates is a nationally recognized law firm which provides long-term care planning, estate planning & estate administration services to Pennsylvania clients from our offices in Jersey Shore, Williamsport, Wilkes-Barre and Scranton.

Marshall, Parker & Associates is the ONLY law firm in the United States with more than two Certified Elder Law Attorneys (CELAs) on it's staff. Each of our five attorneys is a CELA. CELA status, which has been attained by only 37 attorneys in Pennsylvania, is authorized by the Pennsylvania Supreme Court. In approving the CELA professional designation, the Supreme Court found that it provides a measure of assurance to the public that the attorney has an in-depth working knowledge of the legal issues impacting the elderly,

If you or someone you know needs assistance with estate planning or with qualification for Medicaid benefits for nursing home or home care you can trust the specialists at Marshall, Parker & Associates. Please call us toll free at 1-800-401-4552 or email our Scheduling Coordinator, Lynn Wesley at webmail@paelderlaw.com.

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*Attorneys Marshall, Parker, Grebas, Weber & Colbert are certified as Elder Law Attorneys by the National Elder Law Foundation under authorization from the Pennsylvania Supreme Court.

**In addition to her law degree and CELA status, Attorney Colbert holds an advanced legal degree (LLM) in Estate Planning from the University of Miami School of Law.

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