February 14

NAELA Warns House on Vote to Undermine Civil Rights of People with Disabilities

Washington, DC — Under the guise of “drive-by lawsuits,” proponents of the Americans with Disabilities Act (ADA) Education and Reform Act of 2017 (H.R. 620) seek to subvert the rights of people with disabilities to access public places like stores, hotels, and even doctors’ offices.

“I lived through the indignities of life before the ADA. Enforcement under the current law is critical. The proposed bill strips our civil right to access public accommodations and places undue burdens on the individual,” said Michael J. Amoruso, Fellow, CAP, President-Elect of the National Academy of Elder Law Attorneys who is blind, has significant bi-lateral hearing loss and relies on his Seeing Eye Dog and hearing aids for mobility.

Under the ADA, individuals with disabilities can go to court to enforce their rights and to press for timely removal of the barrier that impedes access. H.R. 620 upends that system and puts the onus on the individual with a disability.

“The ADA has been law for more than a quarter century; businesses are already on notice of its requirements,” said Amoruso.

NAELA urges Congress to maintain the integrity of the ADA and vote NO on H.R. 620, the ADA Education and Reform Act of 2017.

About NAELA
Members of the National Academy of Elder Law Attorneys (NAELA) are attorneys who are experienced and trained in working with the legal problems of aging Americans and individuals of all ages with disabilities. Upon joining, NAELA member attorneys agree to adhere to the NAELA Aspirational Standards. Established in 1987, NAELA is a non-profit association that assists lawyers, bar organizations, and others. The mission of the National Academy of Elder Law Attorneys is educate, inspire, serve, and provide community to attorneys with practices in elder and special needs law. NAELA currently has members across the United States, Canada, Australia, and the United Kingdom. For more information, visit NAELA.org.

February 14

11,000 disabled student veterans left without rent and expense money due to computer glitch

Monthly government stipends for 11,000 disabled student veterans are delayed this month, potentially causing the former troops to be late paying rent and other pressing bills.

The subsistence allowance payments are made through the Department of Veterans Affairs as part of its Vocational Rehabilitation and Employment program. The money should have been disbursed Jan. 31 but will be delayed until Feb. 6 because of a “computer glitch,” according to an internal VA memo obtained by The Washington Post.

The memo instructs VA operators to apologize to veterans and tell them their payments are on the way.

The program is popular because it connects disabled veterans with job counseling and pays for them to earn a college degrees or learn technical skills. They are offered internships and help with contacts and résumés.

Army veteran Rick Collin, 30, of Portland, Ore., is one of the veterans who didn’t receive his stipend. As a result, he had to put off paying bills and will now have to pay late fees. Collin, who served in Afghanistan, suffers from severe memory loss and post-traumatic stress, along with chronic back and shoulder pain. He was involved in a car accident on his way to psychiatric therapy at Fort Riley in Kansas.

“This was going to be my first month with money left over after bills, and now that will all go to late fees,” said Collin, who has four children, ages 9, 7, 2 and 9 months.. He is studying photography at Portland Community College.

He said he’s in his fifth week of the term, has yet to receive a computer he was promised and only last week received his camera.

The troubled VA has been under scrutiny for a range of issues, including long wait times for appointments and medical malpractice.

“Any large bureaucracy has their glitches, but anytime veterans are not getting their benefits on time, especially when on a program like this, it’s a real hardship,” said Garry J. Augustine, executive director of 1.3 million-member Disabled American Veterans.

The glitch “has been fixed and it won’t occur again the future,” VA spokesman Curt Cashour said in response to an inquiry from The Post.

“We apologize to the veterans affected by this inconvenience,” he added.

February 7

U.S. government proposes 1.84 percent hike in 2019 payments to Medicare insurers

By Caroline Humer via Reuters.com

The U.S. government on Thursday proposed an increase of 1.84 percent on average in its 2019 payments to the health insurers that manage Medicare Advantage insurance plans for more than 20 million elderly or disabled people.

The proposed rate, which affects how much insurers charge for monthly healthcare premiums, plan benefits and ultimately, how much they profit, was near analyst expectations, and insurer shares were largely unchanged in after-hours trading.

UnitedHealth Group Inc, Humana Inc, Aetna Inc and WellCare Health Plans Inc are the largest sellers of Medicare Advantage health insurance. Under the program, they are paid a set rate by the government to cover member healthcare costs.

The 2019 payment proposal also expands the benefits that insurers can offer in the plans to include items like wheelchair ramps and devices to diminish the impact of health conditions, a positive for insurers competing with traditional Medicare for members.

Kim Monk, managing director of company and investing research group Capital Alpha Partners, said she had expected an increase of 1 percent to 2 percent on average. Payments rates will vary based on geography and on factors like the health of members and the quality ratings of the insurer.

January enrollment data showed that Medicare Advantage 2018 enrollment was 20.9 million and had grown to account for 35 percent of overall Medicare enrollment, BMO Capital Markets analyst Matt Borsch said in a recent research note.

Medicare Advantage competes with the traditional Medicare fee-for-service program. Both have grown as the so-called “Baby Boomer” generation ages into Medicare and together cover more than 55 million people.

Insurers have bet on future growth of Medicare Advantage as the Trump Administration turns to private insurers to control healthcare costs.

The Centers for Medicare and Medicaid Services, a division of the U.S. Department of Health and Human Resources, releases the proposed rate early each year and then opens a public comment period. The final rate released in April could be higher or lower than the proposed one.

In December, CMS provided a forecast for medical services cost growth of more than 4 percent, one of the key components of the total payment rate, which also includes other factors. For instance, the law requires the government to pay similar amounts in the Medicare Advantage plans and the fee-for-service Medicare program, which typically results in a payment cut to insurers.

February 6

People with Medicare Largely Forgotten in Spending Bill Debate

Center for Medicare Advocacy – Matt Shepard: 860-456-7790, shepard@MedicareAdvocacy.org
Medicare Rights Center – Deane Beebe: 212-204-6248, dbeebe@medicarerights.org

Statement from
The Center for Medicare Advocacy and The Medicare Rights Center

— People with Medicare Largely Forgotten in Spending Bill Debate —

Washington, DC – We are relieved that Congress has reached an agreement to fund the federal government through February 8, as any lapse in federal funding can have serious consequences for people with Medicare and their families. We are also relieved that as part of this deal, Congress reauthorized the Children’s Health Insurance Program (CHIP), which provides affordable health coverage for over 9 million children in working families — many of which include people with Medicare.

However, we are concerned that key, bipartisan health policies were not addressed in this legislation. As Congress seeks to resolve outstanding spending and policy debates in the coming weeks, we urge lawmakers not to forget older adults and people with disabilities by overlooking the need to fund and extend these initiatives. The health and financial well-being of people with Medicare is at stake.

Without delay, we urge Congress to fully repeal the harmful Medicare therapy caps. These arbitrary caps create a barrier to accessing necessary therapy services, particularly for individuals with long-term, chronic conditions. The absence of such therapy can lead to avoidable health declines and permanent deterioration. To prevent these outcomes, the cap should be repealed or, at the very least, the process that has allowed individuals to seek an exception to the cap must be reinstated. A permanent fix is urgent to ensure that care is delivered to vulnerable patients, protects beneficiaries from high out-of-pocket costs, and safeguards the long-term viability of the Medicare program.

We also urge Congress to extend funding for community-based organizations to provide outreach and enrollment to low-income Medicare beneficiaries. Previous allocations for these critical activities have led to important, proven results, such as helping 2.5 million beneficiaries in need pay out-of-pocket health care costs they could not otherwise afford. Half of all people with Medicare—nearly 29 million older adults and people with disabilities—live on annual incomes of $26,200 or less, and one quarter live on $15,250 or less. Most people with Medicare simply cannot afford to pay more for health care, and without this assistance, many would be forced to go without care.

These policies have a long history of bicameral, bipartisan support and must be extended immediately. If not addressed soon, people with Medicare will face increased costs, reduced access to care, and decreased health and economic security. Congress must act now to protect and strengthen Medicare by funding and enacting permanent solutions for these vital health care extenders policies.

February 6

Finra Elder-Abuse Rule Could Trigger Delicate Conversations Between Brokers, Clients

Regulation taking effect Feb. 5 requires reasonable effort to find trusted contact, allows brokers to stop fund disbursement

By Mark Schoeff, Jr. via investmentnews.com

A new Finra regulation designed to prevent financial exploitation of seniors will spur what could be delicate conversations between brokers and older clients.

The rule, which goes into effect on Feb. 5, requires that brokers make a reasonable effort to identify a trusted person who can be contacted if the broker is concerned that the client is suffering from diminished mental capacity or is the target of a scam.

The request for a trusted contact must be made at account openings for new clients and during account updates with existing clients.

The regulation also provides brokers with liability protection if they place a hold on disbursements from an account because they think their clients could be harmed.

If the client declines to provide a trusted contact, the broker does not have to keep pushing, according to a set of frequently asked questions posted on the website of the Financial Industry Regulatory Authority Inc.

But that initial conversation could be tricky.

“We have to be real careful with that, especially with seniors, because it’s a touchy subject,” said Amy Daniels, an Edward Jones adviser in Searcy, Ark. “It’s a simple question: Who do they trust? It may be the first time a financial adviser has asked that question.”

Ms. Daniels has been gathering trusted contact information for two years. She’s found that the discussion of what to do if the client declines is a gateway to a family conversation.

“That’s when I really get into the what ifs, in the family meeting,” she said.

RBC Wealth Management brokers also have been obtaining trusted contacts for a number of years. Angie O’Leary, RBC head of wealth planning, recommends that discussion be placed in a larger context.

Conduct “a wealth planning conversation with the client rather than just focusing on the regulatory requirement,” Ms. O’Leary said. “Then they’re having a richer conversation.”

Wells Fargo Advisors has had a program in place since 2014 to protect older clients. The trusted contacts are a key part of the system, according to Ron Long, the firm’s director of regulatory affairs and elder client initiatives.

“We use the trusted contact information as part of the escalation process to protect the client,” Mr. Long said. “In the majority of cases, the trusted contact gets involved and helps resolve the situation. We are well above 50% where a trusted contact or a client or a combination of both are appreciative that we decided to step in.”

The Finra rule gives brokers a safe harbor if they stop disbursements from a client’s account. They can place an initial hold for 15 days and then extend it for another 10 days.

The Finra rule does not require that brokers report suspected elder abuse to regulators or other government agencies, but Joseph R.V. Romano, president of Romano Wealth Management in Evanston, Ill., said that’s what they should do anyway during a disbursement hold.

“The 15 days is giving you the opportunity to escalate this to the proper authorities, like the Adult Protective Services in your state,” said Mr. Romano, a member of the Finra board.

Mr. Romano, who has participated in industry conferences on senior exploitation, spoke about the Finra rule from his perspective as a firm owner, not on behalf of Finra or the board.

APS can investigate the suspected abuse.

“You’re escalating this to an agency that is prepared to make that evaluation,” Mr. Romano said.

At larger firms, such as Edward Jones and Wells Fargo Advisors, escalation means getting compliance or field office supervisors involved in the decision on whether to hold a disbursement.

As the Finra rule is going into effect, several states have implemented or are considering a model elder-abuse rule drafted by the North American Securities Administrators Association. The NASAA regulation is similar to Finra’s but requires that financial advisers report suspected abuse to authorities.

Mr. Long doesn’t foresee conflicts between the rules.

“I think brokers can follow the Finra model and enhance it with whatever state rule may exist,” he said.

The bigger challenge for brokers may be dealing with older clients who resent the idea that they have to prepare for the stage in life where they begin to decline.

Brokers’ “interest in doing the right thing for their client and protecting their client will outweigh the concern about the client pushing back,” Mr. Romano said.

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