Renewal of the PDA Over 60 Waiver

Written By: Attorney Jeffrey A. Marshall , CELA*

Pennsylvania 's Department of Aging Over 60 Waiver program ("PDA Waiver") provides important financial support for thousands of seniors.  The program's fundamental goal is to limit nursing facility utilization and maintain elderly persons in the community for as long as possible. This year, the program will help approximately 13,000 seniors over age 60 meet their long-term care needs at home.

As a Medicaid program, the PDA Waiver receives federal funding based on the Pennsylvania federal participation percentage.  In order to obtain these federal matching funds, the program must be approved by the Centers for Medicare and Medicaid Services (CMS). Once granted, this approval must be renewed every 5 years.  The current 5 year term will expire on June 30, 2008 .  Pennsylvania is preparing to apply for another 5 years of federal funding. 

The PDA Waiver is faced with many challenges as it enters its next renewal term.  We can anticipate that the program will undergo significant alterations. These changes will affect the program's consumers, providers and case managers.

I have written an article intended to help interested readers gain additional understanding of the PDA Waiver program and some of the problems and pressures that are affecting it during this period of renewal and transition.  My article, along with other information related to the PDA Waiver, is available at www.paelderlaw.com [scroll down to the "Aging Waiver Renewal" section in the NewsFlash.]

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

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Quacks Like A Duck: Subsidies to Private Medicare Plans

Center for Medicare Advocacy Editorial

  Apparently not all cost overruns are created equal. Case in point: the well-documented, $150 billion subsidies being paid to private Medicare plans - about 12% more than would be due for enrollees in regular Medicare programs. The Senate failed to follow the lead of the House of Representatives to protect the integrity and stability of the Medicare program by cutting these subsidies. The Administration threatened to veto any bill that even trimmed the subsides, under the guise of being against legislation that reduces choice and access for Medicare beneficiaries.

Thus the subsides continue for another year, notwithstanding repeated studies and little debate about their wastefulness. (See, "Two Insurers Increase Bet on Medicare," Milt Freudenheim , NY Times, 12/5/2007 .) Even with the subsidies, many private Medicare plans are reducing coverage and adding the patient cost-sharing. Meanwhile, all beneficiaries and taxpayers bear the financial burden of maintaining the extravagant overpayments. Unless action is taken, private Medicare plans will collect a total of $150 billion in subsidies, while doctors who care for Medicare patients face a 10% cut in payments.

The private plan overpayments affect all Medicare beneficiaries. They lead to increases in Part B premiums and encourage plan proliferation and marketing abuses by companies looking to benefit from the robust Medicare payments. These overpayments affect all Americans by weakening the financial stability of the Medicare program and by increasing federal expenditures. Even a recent study issued by a for-profit insurance industry group shows that, at best, private Medicare plans spend 300-400% more on administration than traditional Medicare¹.

The lavish subsidies to private plans continue at the same time that we are repeatedly warned, in solemn tones, that "we just can't afford Medicare" for our ever-increasing aging population. The Administration rails at fraud, waste and abuse throughout the federal government, yet the President and powerful minority in the Senate were able to block action to reduce the billions of dollars in overpayments to corporate Medicare. As a result, taxpayers, most people with Medicare, and doctors are losers. Private corporations win - big time.

Some claim that the 20% of Medicare beneficiaries enrolled in private plans will lose benefits and oversight if payments to Medicare Advantage plans are cut. But many private plans are cutting benefits and passing along additional costs to Medicare beneficiaries anyway - even though they continue to be paid far more than traditional Medicare. Further, there is no evidence that private Medicare plans provide more care coordination than is available in traditional Medicare. In fact, beneficiaries who choose an MA plan are likely to find that it limits the doctors and other healthcare providers they can use. The traditional program allows them freedom of choice among almost all providers - that the kind of choice that matters to people.

Private plans do not provide the flexibility or stability of the traditional Medicare program, which covers 80% of all beneficiaries, and they should not be paid more than traditional Medicare. The overpayments to private Medicare plans look, smell, and act like a boondoggle. As Chico Marx said in Duck Soup, "Who you gonna believe, me or your own eyes?"

¹ Council for Affordable Health Insurance, Medicare's Hidden Administrative Costs: A Comparison of Medicare and the Private Sector (Based in part on a technical paper by Mark Litow of Milliman, Inc.), Merrill Matthews, Ph.D. January 10, 2006.           

Reprinted with permission from the Center for Medicare Advocacy

Copyright  © 2007 Center for Medicare Advocacy, Inc.  All rights reserved.

www.medicareadvocacy.org

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Stimulus Package Stimulating More Than Payments

Written By: Jody A. Lose , Planning Specialist at Marshall, Parker & Associates

[As noted in the last issue of the Elder Care Law Alert, seniors who pay little or no income tax may be eligible for stimulus tax payments of $300 ($600 for a couple).   Payments will go to seniors, disabled veterans and veterans' widows who can show $3,000 in Social Security or veterans' disability benefits. In addition, workers who earned at least $3,000 last year, but not enough to pay income taxes, will be eligible for payments of $300.  However, to get a payment this year, you have to file a tax return for 2007.  Planning Specialist Jody Lose offers some advice on where to find some free help in filing the necessary tax return]

  Senior and Low Income advocates are concerned about how many individuals will be able to apply for and receive their Stimulus Payments without losing some of the money to the cost of filing a tax return.

Taxpayers who do not have a regular filing requirement must file a paper claim for their 2007 tax return to receive the minimum stimulus payment.  To help ensure that individuals take advantage of and receive the Stimulus Payments without cost, the IRS lists Free Tax Help Available for low and moderate income workers including veterans.

Free income tax preparation is available through the Volunteer Income Tax Assistance (VITA) program.  The Department of Public Welfare has information on VITA help at http://www.dpw.state.pa.us/ServicesPrograms/CashAsstEmployment/003671773.htm.   The VITA site listing is available at Pennsylvania VITA Site Listing.  All 67 counties in Pennsylvania are served between these two sites.  You can also call 1-800-906-9887 to locate a VITA site near you.

The Tax Counseling for the Elderly (TCE) Program provides free tax help to people age 60 and older.  As part of the IRS-sponsored TCE Program, AARP offers the Tax-Aide counseling program at more than 7,000 sites nationwide during the filing season.  To find an AARP Tax Aide site, call 1-888-227-7669 or visit the AARP website at  http://www.aarp.org/money/taxaide/.  

The AARP website allows you to type in a ZIP code to locate the closest site and their advanced search gives you options on how far you want to travel to find someone in your area.

In Lycoming County , the free AARP sessions are held at the Senior Citizen's Information Center on the 2^nd Floor of Divine Providence Hospital. Those interested in scheduling can call the Center at 326-8657 on Mondays and Wednesdays between 9:30 AM and 12:00 PM .

In Luzerne County , numerous sites are available including the Wilkes-Barre Good Shepard Church at 190 South Main Street .  To contact them, please call 474-9313.

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

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Mark Your Calendars! Marshall , Parker & Associates' Professional Update Scheduled for May 8^th and May 9^th

  Mark your calendars. Marshall , Parker & Associates is proud to present this year's 11^th Annual Professional Update at the Williamsport Genetti Hotel on Thursday, May 8th and at the Scranton Hilton on Friday, May 9th. Each session will be held from 7:30 AM until 12:00 PM .

The Professional Update is an annual event in Northeast and Central Pennsylvania that brings together over 500 elder care professionals to network and learn about the latest trends affecting our seniors.  Because of generous sponsors, we are able to provide this event FREE of charge and provide continuing education credits for little or no cost to you. CEUs will be available for Social Workers, Personal Care Home Administrators, Accountants and Attorneys.

More information, including how you can register, will be available in future editions of the Elder Care Law Alert.

Also, if your company is interested in becoming a sponsor at this year's event, please contact Melissa Bottorf at 321-9008 or at mbottorf@paelderlaw.com.

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Marshall, Parker & Associates Celebrate the Opening of our Scranton Office

 Written By: Melissa Bottorf, Director of Marketing & Public Education

  In an effort to better serve consumers in Lackawanna County , Marshall , Parker & Associates has opened a office in downtown Scranton in the Electric City Building at 329 Penn Avenue .

To celebrate, we will have an Open House with wine and hors d'ouvres on Thursday, April 3, 2008 from 4:00 PM to 6:00 PM .  Stop by for a tour of our beautiful new office, enjoy the company of colleagues and visit with our staff.  If you plan to attend, please RSVP to Molly Symons at 969-2127.

If you or your clients would like to schedule a meeting in our Scranton office, please contact Molly at 969-2127 or e-mail us at webmail@paelderlaw.com.

If you would like someone from Marshall , Parker & Associates to speak at your next meeting, please contact Melissa Bottorf at 570-321-9008 or mbottorf@paelderlaw.com.

Contacting Marshall, Parker & Associates  for Assistance

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

If you or someone you know needs assistance with estate planning or with qualification for Medicaid benefits for nursing home or home care, please call us toll free at 1-800-401-4552. 

 

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

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

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*Attorneys Marshall and Parker 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, Attorney Colbert holds an advanced legal degree (LLM) in Estate Planning from the University of Miami School of Law.

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

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

---

Do you have a friend or colleague who would enjoy reading the Elder Care Law Alert?  If so, please feel free to forward it to them. Simply use the "Forward" button on your e-mail program.

 -Return to 2008 Newsletters-