Florida Supreme Court Rules in Terri Schiavo Case

 Written By:  Attorney Jeffrey A. Marshall , CELA*

  The Supreme Court of Florida has held that a law passed by the Florida Legislature regarding Terri Schiavo is unconstitutional. The law authorized Florida Governor Jeb Bush to order the re-insertion of a feeding tube.  The decision was unanimous. 

Terri Schiavo suffered brain damage in 1990 and relies on a feeding tube to live.  She had no advance health care directive.  A number of medical experts declared that she is in a persistent vegetative state with no hope of recovery.

For years, her husband sought the removal of the feeding tube, arguing that she would not want to be kept "alive" in this way. Terri's parents fought the removal arguing that they thought their daughter could someday regain some of her faculties.

After Florida courts ruled that there was clear and convincing evidence that Terri Schiavo would not have wanted to be kept alive artificially, the feeding tubes were removed for a brief period.  But Florida Governor Jeb Bush pushed "Terri's Law" through the Legislature and ordered the re-insertion of the feeding tubes.

Now the Florida Supreme Court has unanimously held that Terri's law and the action of Governor Bush were an unconstitutional violation of the Florida Constitution. The Court's opinion is available online at

http://www.miami.com/multimedia/miami/news/archive/schiavo.pdf.

Bush v. Schiavo, Supreme Court of Florida , September 23, 2004 . 

Attorney Marshall can be contacted at webmail@paelderlaw.com or at 1-800-401-4552

2005 Medicare Figures Announced:

Part B Premiums to Increase 17%

Written By:  Attorney Jeffrey A. Marshall, CELA*          

  Federal officials have announced the Medicare premium, deductible, and co-insurance amounts that beneficiaries will have to pay in 2005.  The Part B premium paid by most Medicare recipients will increase a whopping $11.60 (17% - from $66.60 to $78.20 a month).  This is the largest increase in history.

According to the U.S. Department of Health & Human Services, the higher premiums "reflect general growth in health care costs, higher payment to physicians and Medicare Advantage coordinated care health plans under the Medicare Modernization Act (MMA), and building trust fund reserves."  Medicare actuaries report that $1.60 of the increase in premiums are a result of an increase in payments to health maintenance organizations and other private plans. Increases in Medicare payments to doctors and higher overall medical costs were responsible for much of the remainder.

Medicare is a federal health insurance program for people 65 years of age and older, some disabled people under 65 years of age, and people with end-stage renal disease.  Medicare plays a significant role in providing health care in the United States .  N ationally, it covers approximately 35 million seniors and 6 million younger people with disabilities.  In Pennsylvania , over 2 million people (17% of the population) are Medicare beneficiaries.

By law, Medicare beneficiaries pay 25% of the cost of Part B benefits with the Federal Government picking up the remainder.  However, as a result of the new Medicare law, higher income individuals and couples will see their premiums double or triple beginning in 2007 since they will be required to pay a larger percentage (up to 80%) of the costs of their Part B benefits. 

Even seniors with modest incomes need to brace themselves. In 2006 most seniors will be hit with additional steep increases in monthly premiums as a result of the prescription drug coverage (Part D) provisions of the new MMA law. By 2006 the average Medicare beneficiary will be paying well over $110 a month in combined Medicare Part B and D premiums. 

The announced Medicare deductibles, premiums, and co-pay amounts for 2005 are as follows:

Medicare Hospital Insurance (Part A)

- Deductible - $912 per Benefit Period ($876 in 2004)

- Coinsurance - $228 a day for the 61st through the 90th day ($219), per Benefit Period; $456 a day for each "nonrenewable, lifetime reserve day" ($438)

- Skilled N ursing Facility Coinsurance - $114 a day for the 21st through the 100th day per Benefit Period ($109.50)

- Hospital Insurance Premium - $375 ($343 in 2004)

- Reduced Hospital Insurance Premium - $206 ($189)

Medicare Medical Insurance (Part B)

- Deductible - $110 per year ($100 in 2004)

- Monthly Premium - $78.20 ($66.60)

The Department of Health & Human Services N ews Release is available online at

http://www.hhs.gov/news/press/2004pres/20040903a.html

Attorney Marshall can be contacted at webmail@paelderlaw.com or at 1-800-401-4552

States Have Option to Count Community Spouse IRA

  Written By:  Attorney Jeffrey A. Marshall, CELA*                                                                                                                                  

  A federal appeals court has ruled that federal Medicaid laws do not protect a retirement plan owned by a community spouse. 

In Pennsylvania , IRAs and other retirement plans owned by the "community spouse" are not counted in determining the financial eligibility of an applicant for Medicaid. The IRA of the non-applicant community spouse is treated as exempt.  This means that the community spouse is not required to use it to pay for the care of the spouse who is receiving care in a Medicaid-participating nursing facility.   

Until 2001, Colorado followed the same rule as Pennsylvania .  The IRA of the community spouse was excluded and protected.  However, in the fall of 2001 Colorado changed this rule.  Since then, retirement accounts owned by a Colorado community spouse have been treated as resources that are available to pay for the care of the institutionalized spouse.

Gene Sellers had a retirement plan, but it was not counted when his wife, Stepheny, first entered a nursing home in 1996. Colorado authorized Medicaid benefits for Stepheny.  Medicaid rules required an annual re-determination of her eligibility.  At the 2002 re-determination, after the new rules took effect, the Colorado Medicaid agency told Gene that his wife no longer qualified for Medicaid because his IRA was now counted as being available to pay for her care. 

Mr. Sellers filed suit in federal court against the state of Colorado .  He claimed that Colorado's new treatment of his IRA violated federal Medicaid law for two separate reasons: (1) a state may not treat a retirement plan owned by a community spouse as being available to pay for the care of his institutionalized spouse, and (2) after an institutionalized spouse qualifies for Medicaid, all of the resources of the community spouse, regardless of value, must be disregarded.  The U.S. 10^th Circuit Court of Appeals disagreed with Mr. Seller's first argument, but agreed with him on the second. 

The federal court found that Congress left it up to the individual states to decide whether the retirement plan of the community spouse should be included in the resources that are deemed available to pay for the care of the Medicaid applicant spouse.  Thus, Colorado was permitted to start counting the IRA, 401k, or other retirement plan of the community spouse. 

On the other hand, the Court said that counting Mr. Sellers' IRA violated federal law because Mrs. Sellers was already on Medicaid when Colorado changed the law.  Resources can no longer be pooled once one spouse becomes eligible for Medicaid.  As expressed by the Court - "Congress appears to have meant what it said: once the institutionalized spouse's eligibility is determined, the state is not authorized to take any resources belonging to the community spouse and deem them available to the institutionalized spouse." [emphasis in original].   

The court ruling has several implications for Pennsylvania .  It means that Pennsylvania could change its current rules to do away with the protected status of community spouse retirement plans. But it also means that any changes cannot be applied to situations where the institutionalized spouse is already on Medicaid. 

In addition, the ruling casts doubt on Pennsylvania 's treatment of the sale of the residence.  If the institutionalized spouse is already on Medicaid, the community spouse ought to be able to keep any proceeds she receives from the sale of the residence.

But, DPW takes the position that the "post-eligibility" sale of the community spouse's home can knock the institutionalized spouse off Medicaid.  The Colorado case makes it clear that DPW's position is in violation of federal law.  Once the institutionalized spouse has qualified for Medicaid, the state is not authorized to treat any resources of the community spouse (including the proceeds of the sale of a home) as being available to the institutionalized spouse.

The federal appeals court case, Houghton and Sellers v. Reinertson, 10^th Cir., No. 03-1074, August 24, 2004 , is available online at http://www.kscourts.org/ca10/cases/2004/08/03-1074.htm.

Attorney Marshall can be contacted at webmail@paelderlaw.com or at 1-800-401-4552

It's not too late to register for the

Alzheimer's Association's 2004 Memory Walks!

Registration is FREE and you can register the day of the event!  Join the Alzheimer's Association in taking steps towards a cure.  

N early 78 cents of every dollar you raise goes directly to promote research, find effective treatments and improve the lives of those affected by Alzheimer's. 

For a list of Walks in your area, go online to www.alzpa.org

For questions about the Memory Walk at Montoursville on October 3^rd at Indian Park , please contact Melissa at 321-9008 or at mbottorf@paelderlaw.com . 

Price Comparison for Drugs is Added to Medicare Website

Written By:  Marshall, Parker & Associates' Planning Specialist, Lisa Barner     

  The Medicare website (www.medicare.gov) provides information about whether you are eligible for the $600 annual credit through the Medicare approved drug discount card.  It will also help you find out about other programs that may help reduce your prescription drug costs (i.e. through specific manufacturers and/or for specific health conditions).  Also, you can view information about the Medicare approved drug discount cards and Pharmaceutical Assistance Programs. 

A new feature has been added to the Medicare website.  This new feature allows a Medicare beneficiary to actually compare prices for prescription drugs.  To do so, you will be asked to select the names of your prescription drugs, specify the dosage and quantity, the price you currently pay for those prescriptions, and your zip code. 

Then, the website provides a listing of the Medicare approved drug discount cards available to you and the names/addresses of the pharmacies in your area.  You are then able to see what price you would actually have to pay at that particular pharmacy when using one of the discount cards.  You can compare prices between pharmacies and using different discount cards at those pharmacies.

The Medicare website also includes an additional way to save money by providing information on a lower cost alternative.  If you are taking a prescription, there may be a drug similar to yours that is priced lower than the drug you are currently taking.  Or, there may be a generic alternative.  To be safe, talk with your doctor. 

The new features may give some seniors more power to compare prices and look for lower costs.

Lisa can be contacted at lbarner@paelderlaw.com or at 1-800-401-4552

Back issues of The Elder Care Law Alerts are available on our website. 

 You can even search our site by a keyword or phrase!

Marshall, Parker & Associates' Holds Bake-Off to Benefit Alzheimer's Memory Walk

  This year the Marshall, Parker & Associates' Memory Walk team will be hosting a Bake-Off to raise money for the Alzheimer's Association.

Staff members will be baking delectable desserts that will be available for tasting on Friday, October 1^st from 9:00AM-1:00PM at the Marshall, Parker & Associates' offices in Williamsport and Jersey Shore. The Williamsport Office is located at 49 East Fourth Street, next to the Brown Library. The Jersey Shore office is located at Allegheny and Broad Streets. Stop in to one of those offices for a sampling of the desserts and to vote for your favorite by placing a dollar in the ballot box.  Whichever dessert receives the most "votes" wins.  All the money raised will go to the Alzheimer's Memory Walk.

Do you enjoy really delicious desserts?  Do you have a favorite staff member at Marshall, Parker & Associates' who you would like to support?  Come out and support them by voting for their baked goods and donate to a great cause at the same time! 

If you have questions about the bake-off or would like to make a donation to our team, please contact Melissa at 1-800-401-4552 or at mbottorf@paelderlaw.com

Josephine Balsamo , Marshall, Parker & Associates' Planning Specialist, Reflects on Scranton's Race for the Cure

Written By: Marshall, Parker & Associates' Planning Specialist, Josephine Balsamo

  On September 11th the Susan G. Komen Breast Cancer Foundation held their annual Race For The Cure fundraising event in Scranton .  It is the largest series of 5K runs/walks in the world.   The purpose of this event is to not only raise funds for a cure for breast cancer but to raise awareness of the disease and educate people about the importance of regular exams and early detection.  It is also a place where people who have experienced the effects of breast cancer, either directly or indirectly, can come together and show their support and commitment. 

That day I took the opportunity to show my support by walking with the other 8,000 + people.  In the past I have participated in other similar fundraising events but this was the first time I joined the Race For The Cure and my experience has been one that left me feeling sad, happy, and inspired all at the same time.  Although I am fortunate in that I never had any kind of experience with breast cancer, I really felt I made a difference just being there. 

As I watched people running and walking, I saw a purpose or meaning in every face.  There were people of all ages who participated.  I saw those with pink shirts with tags on them stating they were a survivor of breast cancer.  Others had pink shirts with tags on them stating they were running/walking in memory of someone they knew who died of breast cancer.  The tags that hit my heart were those worn by little children saying they too were supporting the memory of their mother, or grandmother, or aunt.  It was obvious to me that this disease has no age discrimination for those who it affects, in one way or another.  As I watched each person either walk or run across the finish line, they smiled with joy and each one was congratulated for their accomplishment. 

There was a lot of love among these people during this event.  It is one event I will mark my calendar every year to participate in.  And I would encourage others to join as well.  Even if you haven't been affected somehow by breast cancer, it is a blessing to be there.  And if you have had experience with breast cancer or if you know someone who did, I encourage you even more to participate.  Join our team, form your own team, or walk as an individual. 

Josephine can be contacted at jbalsamo@paelderlaw.com or at 1-800-401-4552

"Paying for Long Term Care" Presentations Set

  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' offers free workshops that help families learn about the options that are available to pay for long term care in the home or in a nursing facility.  Join us for one of these 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.  

- Monday, September 27^th, 2004 at 11:00AM

Marshall, Parker & Associates' Conference Room

1065 Highway 315, Suite 402

Wilkes-Barre

- Tuesday, October 5^th, 2004 at 11:00AM

Marshall, Parker & Associates' Conference Room

1065 Highway 315, Suite 402

Wilkes-Barre

- Thursday, October 7^th, 2004 at 6:00 PM

Ross Library Community Room

Third Floor

Lock Haven

- Monday, October 11^th, 2004 at 5:30 PM

Marshall, Parker & Associates' Conference Room

1065 Highway 315, Suite 402

Wilkes-Barre

- Tuesday, October 12th, 2004 at 6:30PM

Danville Elks Club

1240 Montour Blvd (Rte 11)

Danville

  - Thursday, November 4th, 2004 at 6:30 PM

Lycoming Mall Community Room

Pennsdale

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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