Elder Law

NY Medicaid Supported Adult Day Care Suspended Following Fraud Concerns

Published on: April 30, 2013 | by Ettinger Law Firm

Last week we shared information about the revelations in the New York Times that efforts to curb New York Medicaid costs have been less than successful–mostly because of expanded enrollment in certain programs, like senior day care centers. These assistance centers are locations where frail and sometimes vulnerable elderly community members can stay during the day, while other caregivers–usually adult children–are at work. The facilities offer a way for seniors to avoid being forced to move into a long-term care home.

While useful, concerns have mounted regarding the tactics used by the operators of these facilities to increase enrollment. Owners of the adult care facilities are paid based on the number of eligible New York Medicaid recipients who attend. Therefore, it is in the best interest of the operators financially to increase enrollment–and that is exactly what they have been doing. The increase has been so stark, that some worry that the cost-savings intended (by averting expensive nursing home stays) may be illusory.

Temporary Suspension

Be Aware of Senior Financial Scams with Roll Out of Health Care Law

Published on: April 23, 2013 | by Ettinger Law Firm

From suspicious claims in an email to unsolicited letters, most of us assume we are not naive enough to fall victim to a financial scammer. This is a mistake. It takes only a moment of confusion or a lapse in judgement to provide a fraudster with the the tools they need to steal.

Financial scammers thrive in confusion and unfamiliarity. There is a reason that seniors are targeting more often than others–the elderly may be less familiar with certain aspects of modern technology or culture. As such, scammers are able to poke at their uncertainty in order to gain trust and ultimately take advantage.

These frauds are often connected to current events. Disgustingly, it was only hours after the Boston bombings that some fake charities were set up in an attempt to dupe well-intentioned community members into donating money that would end up in the pockets of criminals. Along the same lines, fraudsters are trying to exploit unfamiliarity and confusion about the high-profile national health care law. Many aspects of the law are set to take effect this year, and most community members are unfamiliar with the details of those changes. Scam artists are stepping into the void, working to use the complexity of the law to solicit funds from unsuspecting community members. Senior citizens are the most likely to be hurt.

NAELA Journal Article on Future of Medicaid

Published on: April 18, 2013 | by Ettinger Law Firm

It can can a confusing, scary, and stressful time for all New Yorkers who use the Medicaid system for necessary health care or for those who suspect they may need it down the road. Not a day goes by that news does not break at either the state or national level regarding payment cuts, service trimming, changes to qualifications, and more.

Considering the complex political dynamics involved in any major decision regarding the New York Medicaid system, it is next to impossible to make predictions with certainty. But many experts in the field are more than eager to share their ideas about what the program might look like in the future.

For example, some may be interested in a recent article a the journal published by the National Association of Elder Law Attorneys (NAELA). Entitled “Whither Medicaid,” the comprehensive article takes a look at all of the major notions about how Medicaid might disappear in coming years and how it may be saved via different alternative arrangements. The article can be read for free online in it’s entirety here.

Find the Right New York Assisted Living Facility

Published on: April 2, 2013 | by Ettinger Law Firm

If stereotypes are to be believed, all living arrangements outside of the home are mired in neglect, confusion, and unhappiness. Virtually no one claims that they want to move into a nursing home or assisted living facility, and many assume that leaving one’s house is only done at the last possible minute and often under duress.

This sort of generalizing about the “horrors” of senior care facilities is often misplaced. There are certainly many low-quality homes and individual residents who despise their living situation. But that is not at all to say that every facility–or even a majority–are like that. The truth is that there are many homes that allow residents to thrive, providing support so that their daily lives are more fulfilled than before, when they lived in their own home (often alone) and without necessary assistance with day to day tasks.

On that topic, a recent New York Times “New Old Age” blog post provides some interesting first-person discussion with one of the nation’s “foremost advocate for people living in assisted living,” Martin Bayne.

Long Term Care Insurance: A Battle of Money & Emotions

Published on: March 28, 2013 | by Ettinger Law Firm

This week the New York Times published a story that will likely ring true to all those who have gone through the process of helping a loved one figure out how to secure the ideal long-term care. It is one of those issues that is easy to talk about in the abstract but that comes packed with intense emotion when one is actually thrust into it and forced to help those closest to them.

One of the scariest aspects to this situation is that it can arise virtually overnight. The NYT story shares the example of one man whose 81-year old parents seemed to go from swimming and playing sports to both becoming frail the next day. Their ailments struck at the same time. His mother developed dementia and passed away within a year of first falling ill. This left the family in a very tough spot. In the midst of grief, they had to make tough choices about how to ensure their father had proper care. Fortunately, the family was in a much better position than many, because the patriarch had purchased a long-term care insurance policy nearly three decades before. That insurance has been able to provide at-home caregivers for the last two years.

That is a key reason why the NY elder law attorneys at our firm encourage families to use long-term care insurance when possible while crafting long-term care plans.

House GOP Proposal & Medicaid

Published on: March 14, 2013 | by Ettinger Law Firm

As most know, the March 1st “sequester” cut deadline came and went without much serious action by policymakers to avert the automatic cuts. This was not unexpected considering policymakers have been very far off on goals for a compromise and because the $85 billion in first year cuts will not necessarily take effect immediately. The real layoffs and consequences that might be felt by most community members will roll out slowly throughout the year, stalling the public outrage and pushing off the political pressure that might force an ultimate budget agreement.

It is important to clarify that while Medicaid cuts were not part of the sequester, potential changes to Medicaid are very much part of potential compromise that could be reached in the coming weeks and months. For that reason, it is important for all local families who rely in any way on New York Medicaid (or who expect to in the future) to understand how potential changes may alter their options.

Latest GOP Proposal

Women May Pay More for Long-Term Care Insurance

Published on: March 5, 2013 | by Ettinger Law Firm

Many of the changes and new rules associated with health insurance as part of the “Affordable Care Act” (Obamacare) will only take effect over the next year or two. One of those new rules prohibits most health insurance providers from making premium pricing decisions based on one’s gender. However, those rules do not apply to companies that provide long-term care insurance.

Therefore it does not come as a huge surprise that the nation’s largest provider of such insurance–Genworth Financial–announced that they will soon being change rate plans to account for the fact that women are more likely to need paid long-term care. According to a Washington Post story, women seeking such insurance on their own will likely see anywhere from a twenty to forty percent increases in yearly long-term care insurance payments. Importantly, the change will only affect new policyholders, as current members should not be affected. Observers note that other long-term care insurance providers will likely follow suit.

The policy change was made, say the company, because of the fact that over ⅔ of all claims on the insurance are made by women. In order to stabilize prices, the company claims that the premium rates needed to better reflect the risk and ultimate need for long-term care. The increased claims by women are likely a product of the fact that they generally live longer and provide care to their own spouses. Men are far likelier to avoid having to make claims on the insurance because their health declines sooner and their spouse often provides care. Elderly women, however, often come to need support after their spouse has passed, and they do not have the luxury of receiving free care from a relative.

New York Elder Abuse Caught on Tape in the Bronx

Published on: February 25, 2013 | by Ettinger Law Firm

The challenges of securing appropriate long-term care are often only understood at the exact moment when that care is needed. After a sudden medical emergency, accident, or other change in condition, many families discover that an elder loved one is in need of long-term help to get by each day. These families then face two difficult questIons: (1) How are we going to pay for it?; (2) How do we know that the quality of the caregivers is sufficient?

For one thing, the financing of long-term care can be secured in many different ways. A NY elder law attorney can explain what options are available in your specific case. Those options may involve insurance, the use of Medicaid Asset Protection trusts, or other unique strategies to save funds even when on the nursing home doorstep. There is no getting around the fact that elder care is quite expensive–startling so–but planning ahead with professionals can save significant sums.

But paying for care is only part of the battle. It is also critical that family members ensure their love ones actually receive the care they deserve, no matter what facility they enter. Sadly, without proper oversight, seniors may face severe neglect or outright abuse by those charged with their well being.

Struggling to Pay for Burial Costs After Death

Published on: February 21, 2013 | by Ettinger Law Firm

There is no getting around the fact that certain costs will be incurred near the end of life. Even if you are in great health, live at home until the very end, and require no extra caregiving of any kind, your passing will come with certain financial challenges for your family. Most obviously, there are burial and funeral details to be paid for. Yet, more frequently than many realize, local families are forced to struggle and scrape just to put together enough money for those final arrangements. The challenge can be particularly tough for elderly individuals who have very limited incomes and no means to earn more.

The struggle was highlighted in a sad case discussed this week by KOMO News. The story details an estate sale that an elderly woman is having in order to pay for the burial costs of her recently-passed husband. Her husband of 46 years recently died after living his final two years with Alzheimer’s. As families with relatives facing cognitive mental issues know, the costs associated with this care can be staggering. It doesn’t take much for middle class families to be financially wiped out in short order when dealing with the ancillary costs of Alzheimer’s care.

In this case, the 88-year old widow, Elsie, had only $9 to her name at the time of her husband’s passing. In describing the sad situation the article author explained, “Elsie is alone in this world. At 91, she has outlived all her friends. She has no children, no relatives of any kind, and she is broke.”

Does New York Need a Mandatory Elder Abuse Reporting Law?

Published on: February 12, 2013 | by Ettinger Law Firm

It is commonly understood that elder abuse is a serious concern that often goes unreported. But there remains less certainty about the best ways to address the problem. A recent Buffalo News editorial argued that more needs to be done at the state and federal level to tackle the issues.

For one thing, New York is one of only three states in the country that does not have a law which requires reporting of elder abuse and financial exploitation. The idea is that community members–particularly those in situations where elder abuse might be observed–must be made aware of the gravity of the situation and effectively forced via the law to report their suspicions.

The story points to recent research by Cornell University academics entitled “Under the Radar: New York State Elder Abuse Prevention Study.” Disturbingly, the report found that for every case of elder abuse that is reported to authorities, another 44 cases are never shared. That estimate is similar to those made by previous researchers. When all forms of elder abuse are considered (including financial exploitation by family members), other studies have found that upwards of 95-99% of exploitation is not reported.