May 24

Maryland Repeals Filial Responsibility Law

Maryland’s filial responsibility law provided that adult children are obligated to financially support a destitute parent with food, care, shelter, and clothing. The law was not used much in nursing home cases because Maryland law prohibits a nursing home from holding adult children responsible for a parent’s nursing home bill unless the child consents in writing to be financially responsible. However, the law could have been used when a parent under age 65 was under the care of a psychiatric hospital.

The repeal was a bipartisan effort. The arguments for repealing the law were that filial responsibility laws were a holdover from Elizabethan times, and that a parent’s failure to exercise sound financial discretion should not burden the parent’s adult children. To read the full repeal, go here: http://mgaleg.maryland.gov/2017rs/chapters_noln/ch_540_sb0676t.pdf.

April 19

HHS/CMS Letter to Governors Signals Medicaid Priorities

In a letter to governors, Secretary of Health and Human Services Tom Price and Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma outline the key areas the administration wants to work on with states. The letter describes “a new era” where states have more freedom to design programs to meet the diverse needs of their populations.

Included as a priority in the letter is making the state plan amendment process “more transparent, efficient, and less burdensome,” including facilitating expedited review of waivers. The letter indicates that CMS will be more likely to approve waiver programs that have already been approved in another state. The letter also states that CMS will provide extra time for states to comply with the 2014 Home and Community-Based Services Rule.

Other priorities included in the letter are supporting innovative approaches to increasing employment and community engagement, aligning Medicaid with private insurance, and providing states with more tools to address the opioid crisis.

To read the letter, click here.

April 10

SNT Fairness Act Becomes Law

The Special Needs Trust Fairness Act, federal legislation that allows people with disabilities to create their own special needs trusts instead of having to rely on others, is now law.  The measure was included in the 21st Century Cures Act, a $6.3 billion package of health-related initiatives signed by President Obama on December 13, 2016. 

As the National Academy of Elder Law Attorneys (NAELA) put it in a press release announcing the Fairness Act’s clearing its final legislative hurdle, the measure “corrects a patently false and degrading error in the law that presumed all individuals with disabilities lacked the capacity to handle their own affairs.”  The legislation, which Rep. Glenn Thompson (R-Pa.) introduced in 2013, will finally allow beneficiaries with capacity to create and fund their own special needs trusts. 

In addition to Rep. Thompson, NAELA applauded Frank Pallone (D-N.J.) along with Sens. Chuck Grassley (R-Ia.) and Bill Nelson (D-Fl.) “for their bipartisan dedication to ensuring this common sense fix became law.”

The Fairness Act will apply to trusts established on or after the date that the Cures Act was enacted.  

The Social Security Administration has published an emergency memorandum incorporating the change into the Program Operations Manual System (POMS).  For details, see New Jersey ElderLawAnswers member Donal D. Vanarelli’s blog post here.

The SNT Fairness Act can be found in Title V, Section 5007 (page 440), of the Cures Act.  To read the 21st Century Cures Act, click here.

For background on the Fairness Act, click here


April 3

New Bottom Limit of MMMNA Announced

The Department of Health and Human Services (HHS) has announced the new poverty income guidelines for 2017. The new guidelines mean that the lower limit of the minimum monthly maintenance needs allowance (MMMNA) will rise to $2,030 in the 48 contiguous states and the District of Columbia, effective no later than July 1, 2017. The current amount is $2,002.50.  The upper limit, announced earlier, is $3,022.50

The new bottom limit figure will be $2,536.25 in Alaska and $2,333.75 in Hawaii. The minimum MMMNA is 150 percent of the monthly poverty guideline for a couple.

The guidelines were among 23 rules that the Trump administration withdrew from the Federal Register pending review but the guidelines have since been republished by HHS’s Assistant Secretary for Planning and Evaluation (ASPE).  For that document, go to: https://aspe.hhs.gov/poverty-guidelines  

January 11

Medicare Advantage “Do-Over” Window Will Soon Close

Medicare’s annual open enrollment period ended last month, but certain beneficiaries who regret their selection can get a do-over from now through mid-February. The Medicare Advantage disenrollment period runs from Jan. 1 through Feb. 14. During this time, beneficiaries in private Medicare Advantage plans can switch to Original Medicare and, if desired, select a Part D drug plan. This is the only move permitted: Those in Original Medicare can’t switch to Medicare Advantage and those already in Medicare Advantage can’t switch to a different Medicare Advantage plan. Unless those beneficiaries qualify for a special enrollment period, they will have to wait until the fall to make any changes to their coverage that will be effective at the start of 2018. The winter disenrollment period for Medicare Advantage may be easy to miss. It’s not accompanied by the same advertising blitz that characterizes the annual fall open enrollment, when the airwaves fill with commercials for Medicare Advantage and Part D drug plans. For those unhappy with their Medicare Advantage coverage, it’s an important chance to leave your plan, regardless of whether you enrolled years ago or during the recent open enrollment. (For tips on navigating Medicare in general, check out Money’s comprehensive guide.) Beneficiaries aren’t limited in the number of times they can take advantage of the Medicare Advantage disenrollment period during their lifetimes.

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