The Stone Law Firm wishes you a healthy, prosperous, and happy 2019! We greatly appreciate the opportunity to provide elders and special needs individuals in the community with legal services. In 2019, we look forward to assisting clients with navigating complex Medicaid long-term care programs and other public benefits, and with estate planning to maximize independence and protect assets for the benefit of clients and their families. Our blog will also focus on key issues in improving dementia care, quality of care, and therapy services in long-term care nursing facilities. Happy New Year to all!
Medicare Advantage (MA) plans, offered by private insurance companies, as an alternative to the traditional Medicare program, are improperly denying many medical claims, according to a New York Times article. Based on a new report by the U.S. Dept. of Health and Human Services, the "plans, which now cover more than 20 million people - more than one-third of Medicare beneficiaries - have an incentive to deny claims 'in an attempt to increase their profits.'" Read the full article here.
According to the Center for Medicare Advocacy, "Enrollment in a private MA plan, rather than traditional Medicare, is often a disadvantage for people when they get sick or injured and really need coverage and care. They then find their health care options limited by plan networks, prior authorization requirements and restrictive interpretations of coverage rules." Nonetheless, the Administration is working to steer beneficiaries into MA plans during the 2018 annual enrollment period which ends December 7, 2018. Soon, however, you will have another opportunity to change from a private MA plan to traditional Medicare, according to the Medicare Handbook.
You Can Still Make Changes to Your Coverage after December 7. Here's how:
Starting in 2019, between January 1–March 31 each year, during the Medicare Advantage Open Enrollment Period:
• In addition to changing Medicare Advantage plans, you can disenroll from your Medicare Advantage Plan and return to Original Medicare. If you choose to do so, you’ll be able to join a Medicare Prescription Drug Plan.
During this period, you can’t:
• Switch from Original Medicare to a Medicare Advantage Plan.
You can only make one change during this period, and any changes you make will be effective the first of the month after enrollment.
New rules for the Veterans Aid and Attendance Pension may be published in December, 2018. Originally published in early 2015, the proposed amendments would implement new requirements and restrictions for evaluating income, assets, "net worth" and asset transfers for pension eligibility purposes. The proposed amendments would also make "statutory changes affecting pension beneficiaries who receive Medicaid-covered nursing home care." The Trump administration has completed its review of the proposed rule changes and has scheduled publication of the Final Rule in December, 2018, according to regulations.gov.
The Texas Legislature has approved major changes to the Statutory Durable Power of Attorney (SDPOA) - the form that allows you to appoint an agent to act for you in certain financial matters - making it imperative to review and consider updating your power of attorney. Legislators expanded the instrument to include important new powers - including "hot powers" - which may be granted to your agent and may be especially useful for Medicaid Planning, Estate Planning, and Tax Planning purposes. New agent duties and responsibilities were also added.
The so-called "hot powers" include authorities which may be essential in elder law situations: for example, the authority to create a trust, to change a beneficiary designation, to create a right of survivorship, and to transfer property to the agent. Previously elder law attorneys added similar authorities as customized "Special Instructions," however now that the Legislature has statutorily defined these authorities and provided new language for implementing them, certain areas of the law that were "gray" are more clearly defined and easily enforced. All power of attorney documents should be reviewed in light of these major changes.
In addition, your power of attorney may now authorize your agent to appoint an alternate agent not named in the document, if no named agent or alternate agent is available to act, making it unnecessary to draft a new power of attorney in this situation.
The general power of attorney was updated to include a new section to authorize the agent to act with respect to digital assets and the content of an electronic communication. The new language empowers the agent to access digital assets as provided in the Texas Revised Uniform Fiduciary Access to Digital Assets Act, which was also recently enacted.
The Legislature also added an important new process for acceptance of a power of attorney by a bank or other person. The bank, insurance company, or other "person" is required to accept the power of attorney unless one or more statutorily defined grounds for refusal exist. These new provisions and powers make the Texas SDPOA more consistent with the national standard, or the Uniform Power of Attorney Act.