Nursing Facility Assessment Law Enacted

Written By: Attorney Jeffrey A. Marshall, CELA*

  A bill placing a new assessment on nursing homes was signed into law by Governor Rendell on September 30^th.  House Bill 297 that provides for assessments on nursing facilities was enacted as Act 25 of 2003. The bill passed in the House unanimously and in the Senate by a 45-3 vote. The new law authorizes the Department of Public Welfare to implement a health care-related fee on non-federal, non-public long term care nursing facilities licensed by the Department of Health. The assessment is authorized for the period from July 1, 2003 through June 30, 2007 .

The revenues raised by the assessment will allow Pennsylvania to receive additional Federal Medicaid matching funds. All revenues generated by the fee, plus the related federal match, will be placed in a special restricted account to be used solely to increase payments for nursing facility services provided by Medical Assistance nursing facility providers. 

The Secretary of the Department of Public Welfare (DPW) with the approval of the Governor will determine the assessment rate on an annual basis. The assessment rate is limited by federal regulations; and a nursing facility that disagrees with its assessment will be able to request a review by the Bureau of Hearings and Appeals. DPW may deduct any unpaid assessment (plus interest) from the Medical Assistance payment due to the facility.     

A copy of the new law is available online at the following location.

http://www2.legis.state.pa.us/WU01/LI/BI/BT/2003/0/HB0297P2623.pdf.

The assessment was the subject of an earlier article in The Elder Care Law Alert.  That article, "Governor's Proposal Would Raise Medicaid Revenues for Many Nursing Homes" is available at the following link.  http://www.paelderlaw.com/uninsured.html.

 

Getting Your Prescriptions From Canada: The Issues Around Drug Re-Importation

[The following article is reprinted from the October 2003 issue of the Senior Health News, a publication of the Pennsylvania Health Law Project.  It is copyrighted by the Pennsylvania Health Law Project and is re-produced by permission.  More information about The Pennsylvania Health Law Project is available online at www.phlp.org.]

  In the past few months there has been a lot of news about buying prescriptions from Canada or other neighboring countries. This is called drug re-importation. Here is an overview of drug re-importation - what it is and why it is making news.

What is drug re-importation?

Drug re-importation is when American consumers buy prescription drugs from foreign pharmacies and distributors. It is called "RE-importation" because most of these drugs were made in the United States and then imported to the other countries.

Why are consumers buying their prescriptions from other countries?

In most cases, prescription drugs are sold in foreign countries for less money than they cost here in the United States. More and more people are buying their medications this way as prescription drug prices continue to grow in the United States.

How do consumers buy prescription drugs from other countries?

Consumers buy the prescription drugs through on-line pharmacies, through the mail, or by going to the countries where the drugs are cheaper.

Is it legal to buy prescription drugs from other countries?

It is currently illegal to bring foreign drugs into the United States . However, the Food and Drug Administration, which regulates prescription drugs in the United States , is not presently enforcing the law against individuals who purchase prescription drugs from other countries. The FDA has begun to enforce the law against companies that are re-importing. The FDA filed a lawsuit against Rx Depot, which runs storefronts that help consumers purchase prescription drugs from Canada . Another company, CanaRx Services, which also helps consumers buy prescription drugs from Canada , received a warning letter from the FDA, informing the company that its services are illegal.

Are any state or local governments participating in drug re-importation?

Yes. Even though drug re-importation is technically illegal, the city of Springfield , Massachusetts started a drug re-importation program for its employees. City employees, retirees and dependents who have health insurance through the city can fax their drug orders to a group of Ontario pharmacies. They receive their prescriptions through the mail. The city expects to save at least $4 million on the program. Illinois , Maine and Vermont have also expressed interest in starting a similar program.

Will re-importation become legal?

It is possible that some form of re-importation will become legal. In the last few years, there have been numerous proposals on legalizing re-importation of prescription drugs. This summer, the U.S. House of Representatives passed a bill that would allow drug re-importation from Canada and other industrialized nations. Both the House and Senate Medicare reform bills contain provisions legalizing some drug re-importation. And, House Democrats signed a letter saying they would be "unlikely to support a Medicare drug benefit" that does not allow some kind of drug re-importation.

Who Opposes legalizing drug re-importation?

The FDA and the pharmaceutical companies oppose drug re-importation. The FDA says that it cannot guarantee the safety of drugs that are imported from other countries. Drugs in other countries may be regulated differently than in the United States . The pharmaceutical companies oppose drug re-importation for safety and market reasons. They say lower prices will reduce research and development because the drug companies would make less money on the drugs sold.

Buying Prescription Drugs On-line

[The following article is also reprinted from the October 2003 issue of the Senior Health News, a publication of the Pennsylvania Health Law Project.  It is copyrighted by the Pennsylvania Health Law Project and is re-produced by permission.  More information about The Pennsylvania Health Law Project is available online at www.phlp.org.]

  One way many people are trying to save money on prescription drugs is by buying them through the internet. If you are considering purchasing your prescription drugs through an online pharmacy, there are a few things you should know.

Types of Online Pharmacies.

There are four different kinds of Online Pharmacies:

1. "Brick and click" pharmacies - These pharmacies do not prescribe medication, but require you to present a valid prescription before you can get your medication.

2. "Prescribing-based" pharmacies - These pharmacies give you a medical diagnosis for an on-line patient without providing an actual physician exam.

3. "No-prescription" pharmacies - Patients may buy remedies from these pharmacies without a prescription over the Internet.

4. "Business-to-business" pharmacies - These pharmacies are controlled by an insurance company. The pharmacy customizes the web site to meet the corporate image of the insurance company. The pharmacy takes orders, processes payments, and provides customer service for transactions and clinical questions.

Things to consider about Purchasing Prescription Drugs from Pharmacies Online.

1. Cost- Prescription drugs are often cheaper through on-line pharmacies than in a local pharmacy.

2. Convenience- For people who are disabled or homebound, buying prescription drugs from an on-line pharmacy can be much easier than trying to go to the local pharmacy. You can buy your medications 24 hours a day and often have a wide selection of products.

3. Privacy- For those who do not want to discuss their medical needs in a public place, the on-line pharmacies maybe offer more privacy. However, some pharmacies may sell your information to other companies.

4. Errors- There could be problems with the medication itself, such as the chance of medication that has been misbranded or has been harmed in some way.

5. Storage- Sometimes the medications have been stored in a way that may damage their potency or safety.

6. Source- You may not know where the drugs were made, whether they have been approved for sale in the U.S. , etc. You may not know the location from where the drugs are being sent.

7. Safety-

* When people order prescription drugs without a prescription, there may be a great chance of a problem with the prescription drug interacting badly with a drug you are already taking.

* Regulation of on-line pharmacies is not as strict as that of your local pharmacy and there is a greater possibility of unsafe, unproved, or counterfeit drugs or devices being sold on-line.

Some safeguards

The National Association of Board Pharmacies (NABP) has a certification program where a pharmacy can establish a Verified Internet Pharmacy Practice Site (VIPPS).  This certification is voluntary. To earn a VIPPS seal, a pharmacy must comply with state law requirements. The NABP inspects the pharmacy and verifies the status of the pharmacy, its pharmacists, and others through the NABP database. The certification process lets consumers know that the on-line pharmacy is legitimate. In October 2003, the NABP web site listed fourteen on-line pharmacies as VIPPS certified. You can see the list of pharmacies at: http://www.nabp.net/vipps.

Medicare Part B Premium to Rise 13.5%

Written By: Attorney Jeffrey A. Marshall, CELA*

  The Bush Administration has announced that the Medicare Part B Premium will rise to $66.60 a month next year, an increase of $7.90 per month.  The Part B premium covers physician services, hospital outpatient care, durable medical equipment, and other services outside hospitals. 

The increase amounts to a 13.5% increase over the 2003 premium, and a 52% increase over the premium of $43.80 that retirees paid in 1998.  The increase does not include any costs related to the new Medicare prescription drug coverage that has passed both houses of Congress and is currently in Conference. Prescription drug premiums would likely not begin until 2006.  

Planning for Disabled Children Lecture Upcoming in Sunbury

Attorney Kathy Kron and Geriatric Planning Specialist Suzanne Starr of Marshall, Parker & Associates will be presenting a free educational lecture, "Special Needs Trusts: Planning for Disabled Children, on Wednesday, November 5^th at 6:00 PM at Special Locations in Sunbury.  The event is being sponsored by the Northumberland County MH/MR and is intended for parents of disabled children and others who are interested in learning about special needs trusts.

Attendees at this free lecture will learn how special needs trusts can allow an individual or couple to give money to a disabled child without causing a loss in government benefits and how to create an estate plan that can enhance the lives of disabled loved ones. 

For more information about the event, or to reserve your spot, please contact Anne Kalinoski, Program Coordinator for Northumberland MHMR at 570-495-2004 or at akalinoski@norrycopa.net

Marshall, Parker & Associates Team Participates in 2003 Alzheimer's Memory Walk

  According to the Alzheimer's Association, "Memory Walk is the Alzheimer's Association major fund-raising event. Each fall, thousands of people walk with the Alzheimer's Association to help make a difference in the lives of people affected by Alzheimer's disease. The money raised by Memory Walk participants helps fund vital programs and services such as Helpline, support groups, and educational events. Memory Walk also allows people with the disease, their families, and their friends-and those who wish to support those affected-to celebrate all the successes and strides being made".  Marshall, Parker & Associates was proud to be a sponsor for this year's event.

The Elder Law Firm of Marshall, Parker & Associates' "Dream Team" participated in this year's Alzheimer's Association Memory Walk on October 12^th, at Indian Park in Montoursville.  The team raised over $500 to help support the North East PA Chapter of the Alzheimer's Association.

For more information on the Pennsylvania Alzheimer's Association or to donate to the Memory Walk, visit its website at www.alzpa.org

 

 "Understanding Medicaid" Presentations Set for Wilkes-Barre and Lewisburg"

  Getting good information about options for long term care is critically important for seniors. Four out of every ten people reaching age 65 will spend some time in a nursing home and many more will require home care and assistance with daily living.

The Elder Law Firm of Marshall, Parker & Associates' is known throughout Pennsylvania for the expert help we provide seniors who are faced with long term care needs. We help families struggling to care for their loved one at home find the programs and financial help they need.  

If nursing home placement becomes necessary, we work with the facility to help make the transition go as smoothly as possible. We make certain that the nursing facility gets paid in a timely manner while helping the family qualify for government programs that help pay the costs.  

Marshall, Parker & Associates' occasionally holds free educational forums to help educate families about the options that are available to pay for long term care in the home or a nursing home.  Join us for one of these free presentations and learn what you need to know about how to get the help you need and protect your family's financial security when your spouse or parent is faced with a long term illness.             

Each presentation is FREE and open to seniors, their families, elder care professionals, and anyone else who needs to learn more about this complex subject.  Each presentation lasts about 1 ½ hours, including a "Question & Answer" Session.  

 

 - Wilkes-Barre : Saturday, October 25^th at 10:00 AM at The Woodlands

- Wilkes-Barre : Thursday, November 6th at 3:30 PM at

Marshall, Parker & Associates' Office,

Cross Creek Pointe, 1065 Highway 315, Suite 402

-Lewisburg: Thursday, November 13^th at 6:30 PM at Evan Community Health Building , Staples Plaza , Rte 15

- Wilkes-Barre : Thursday, November 20th at 3:30 PM at

Marshall, Parker & Associates' Office,

Cross Creek Pointe, 1065 Highway 315, Suite 402

Reservations are suggested, but not required.  SIGN UP ONLINE or call 1-800-401-4552 for more information or to reserve your spot for one of these free seminars!

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Does Your Club Or Organization Need A Speaker?

If you are interested in having an attorney or geriatric planning specialist from

The Elder Law Firm of Marshall, Parker & Associates' speak to your group, or at an upcoming event, please contact

our Public Education Coordinator,  Melissa Bottorf

at mbottorf@paelderlaw.com or 1-800-401-4552  

*Attorney Marshall is certified as an Elder Law Attorney by the National Elder Law Foundation under authorization from the Pennsylvania Supreme Court