Elder Law

Medicare Rehab Requirements Relaxed?

Published on: February 27, 2014 | By McCulloch & Miller, PLLC

What does this mean? Imagine you have a severe stroke. Before Jimmo, most people thought Medicare would pay for physical therapy only as long as that PT was helping you get better. For instance, Medicare would pay if therapy helped increase the number of steps you could walk without assistance. Now, Medicare will pay for PT even if it only helps you maintain your current ability to walk.

Whenever the rules for receiving Medicare benefits change it has a real impact on real beneficiaries and patients. Sometimes legal changes occur literally overnight, while at other times the changes are more subtle. After a landmark lawsuit a year ago, there may be some tangible effects to the system – for the better. This is especially the case when an elderly loved one requires skilled nursing or physical therapy.

The landmark case was Jimmo v. Sebelius. Recently, Forbes explored the legal evolution Jimmo sparked in an article titled “When Medicare Will Pay for Skilled Nursing or Physical Therapy.”

When To Shut Down The Pacemaker

Published on: February 21, 2014 | By McCulloch & Miller, PLLC

[Pacemakers] prolong lives, but “all those people will face decisions down the road,” Dr. Mueller said. “’Do I keep it going? Do I turn it off?’” Physicians have similar questions, including what kinds of patients confront these choices and who usually winds up making these decisions.

Do you or a loved one live with a pacemaker or implanted defibrillator? These devices keep the clock ticking, so to speak. But when you are making end-of-life plans, when is the right time to turn the pacemaker off? This scenario is all too common and is presenting challenges in geriatric medicine and palliative care.

Recently, The New Old Age Blog took a look at this perplexing issue in an article titled “A Decision Deferred: Turning Off the Pacemaker.”

End-Of-Life Planning – Four Must-Have Documents for Houston Residents

Published on: February 19, 2014 | By McCulloch & Miller, PLLC

To avoid a crisis in your family, be sure your parent has the following documents.

Some of the most important end-of-life planning should include making sure your loved ones have the legal right to take care of you later in life. Accordingly, there are some essential legal documents you really must have in place to make this happen.

End-of-life planning has much to do with medical planning. Doctors can only do what you ask of them. But what if you cannot communicate your own wishes to them? What then?

Medicaid’s Give And Take

Published on: February 18, 2014 | By McCulloch & Miller, PLLC

The fear that the government could one day seize their homes is deterring some people from signing up for Medicaid.

Medicaid comes with a lot of give and take. It is a safety net for those who need it, but it does come with its drawbacks. One drawback many are now discovering is “Medicaid Asset Recovery.”

So, what is “Medicaid Asset Recovery”? In layman’s terms: after you pass away the government can recoup the benefits you received from Medicaid by taking from your remaining assets, which usually means your house.

Admitted Vs. Observation: Awareness Of Medicare’s Coverage in Houston

Published on: February 12, 2014 | By McCulloch & Miller, PLLC

If you or a family member land in the hospital as an observation patient and think you should be admitted, it’s better to act sooner than later.

When it comes to whether or not care is covered by Medicare, the distinction between being "admitted" or just "under observation" is critical. This is especially important when it comes to whether your elderly loved one will have nursing home coverage after discharge from the hospital.

Understanding the meaning of observation status is essential. Once you do, then you will need to learn all the administrative tricks, twists and turns – and, yes, even to know how to fight it.

No Beneficiary Designation? An IRA “Uh-Oh” for Houston Families

Published on: February 6, 2014 | By McCulloch & Miller, PLLC

We say it over and over again. Check your beneficiary forms! Don't let your retirement funds go down the drain.

Anything involving the court system is rarely quick and painless (probate anyone?). Fortunately, IRAs can easily be transferred to your loved ones outside of probate simply by completing a beneficiary designation form. But what if there was no beneficiary designation form completed? Uh-oh, what now?

The slightly messy situation of an IRA left without a beneficiary was tackled recently by Ed Slott’s blog, The Slott Report. The article, titled “There is No Beneficiary on the Retirement Account: Now What?,” is the perfect encouragement to ensure that every beneficiary form is filled out and up to date.

Medicaid Lookback Rules for Houston Families

Published on: January 31, 2014 | By McCulloch & Miller, PLLC

My mother gave me money in 2009. Now (2014) she is in a nursing home and needs to get Medicaid. Does that money need to go back in her account because of Medicaid's five-year lookback?

Medicaid is wound tight with very well-intentioned rules to stop people from taking advantage of or “beating the system.” These rules are meant to prevent fraud. Unfortunately, the rules intended to stop outright fraud can sometimes get in the way of those who do play by the rules.

The most common problem families run into is the so-called “lookback” period. You can easily run afoul of the 20/20 hindsight of Medicaid and thereby threaten the care your elderly loved one needs. This common conundrum of the lookback period was recently updated in a Q&A and supporting guide produced by ElderLawAnswers. In fact, the common question that sparked the post is the same as the title: “Should I Return Money My Mom Gave Me So She Isn't Penalized by Medicaid?”

Medicare Denied? Appeal Your Houston Application.

Published on: January 28, 2014 | By McCulloch & Miller, PLLC

If a beneficiary disagrees with a decision, there are reconsideration and appeals procedures within the Medicare program.

Medicare approvals can be tough at times, and some may find their claims come up with the big "D" – denial. So what happens when Medicare denies a beneficiary’s claim for care?

While it is not always smooth sailing, it is important to know that you are not without recourse. You can appeal Medicare decisions to refuse coverage for needed care, and sometimes you simply must.

The Law Blurs The Lines Between Life And Death for Houston Families

Published on: January 23, 2014 | By McCulloch & Miller, PLLC

"It seems like there seems to continue to be confusion about what it means to die using neurologic criteria," said Cynda Hylton Rushton, professor of clinical ethics at Johns Hopkins University.

Two recent medical cases are making headlines over the often blurry lines between life, death, medical ethics and the law. When confronting issues like brain death and life support, what is the "right" decision for the patient?

CNN recently considered these two cases in the headlines and the surrounding issues in an article titled “When 'life support' is really 'death support'.”

More Medicare Coverage For Mental Health Costs May Aid Houston Residents

Published on: January 21, 2014 | By McCulloch & Miller, PLLC

“Hopefully, older adults who previously were unable to afford to see a therapist will now be more likely to do so,” said Andrea Callow, a policy lawyer with the Center for Medicare Advocacy.

Now that 2014 is officially here, it's time to start reviewing the Obamacare provisions that went into effect January 1. One change for elderly and Medicare beneficiaries that went into effect has been on the books since 2008 through the Medicare Improvements for Patients and Providers Act. Medicare will now cover costs for psychological care to the same degree as physical medical costs at the 80/20 Medicare/Beneficiary split.

The New York Times – The New Old Age Blog took note of this change in a recent article aptly titled “Medicare to Cover More Mental Health Costs.” It seems psychological issues are often the most directly felt difficulties in the life and wellbeing of elderly Medicare beneficiaries. With the new change, the long-held gap in coverage between the costs for physical medicine and psychological care has now been closed. Consequently, more elderly beneficiaries will be able to afford the care that is uniquely suited to their own needs and happiness.