Higher health-insurance rates coming to R.I. for 2018

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A number of Rhode Island health-insurance companies have been granted permission for double-digit rate increases to their premiums for 2018.

The new rates released Thursday by the Office of the Health Insurance Commissioner range from increases of 5 percent to 12.1 percent. In six of 12 cases, the rates approved are less than the increases requested by the insurance companies. Collectively, the 2018 premium approvals are $16.7 million lower than what insurance companies requested.

The rate increases approved for the individual market, which covers roughly 47,000 people, are: Blue Cross Blue Shield of Rhode Island, 12.1 percent; Neighborhood Health Plan of Rhode Island, 5 percent.

The rate increases approved for small-group market, which covers roughly 60,000 people, are: Blue Cross Blue Shield of Rhode Island, 7.3 percent; Neighborhood Health Plan of Rhode Island, 6.3 percent; United HealthCare HMO, 8.1 percent; United HealthCare PPO, 8.1 percent; Tufts Health Plan HMO, 6 percent; Tufts Health Plan PPO, 6.5 percent.

The rate increases approved for the large-group market, which covers roughly 123,000 people, are: Blue Cross Blue Shield of Rhode Island, 10 percent; United HealthCare, 8 percent; Tufts Health Plan HMO, 9.8 percent; Tufts Health Plan PPO, 10.4 percent.

Source: Higher health-insurance rates coming to R.I. for 2018

Trump Signs Bill to Fund Veterans Medical Care Program

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Veterans to receive private medical care

President Donald Trump

President Donald Trump has signed an emergency spending bill that will pump more than $2 billion into a program that allows veterans to receive private medical care at government expense. Trump, who made improving veterans care a central campaign promise, signed the VA Choice and Quality Employment Act while at his New Jersey golf club on Saturday.

The bill, which addresses a budget shortfall at the Department of Veteran Affairs that threatened medical care for thousands of veterans, provides $2.1 billion to continue funding the Veterans Choice Program, which allows veterans to seek private care. Another $1.8 billion will go to core VA health programs, including 28 leases for new VA medical facilities.

Why the new Veteran program?

The Choice program was put in place after a 2014 wait-time scandal that was discovered at the Phoenix VA hospital and spread throughout the country. Veterans waited weeks or months for appointments while phony records covered up the lengthy waits. The program allows veterans to receive care from outside doctors if they must wait at least 30 days for an appointment or drive more than 40 miles to a VA facility.

VA Secretary David Shulkin has warned that without legislative action, the Choice program would run out of money by mid-August, causing delays in health care for thousands of veterans. The bill will extend the program for six months. Costs will be paid for by trimming pensions for some Medicaid-eligible veterans and collecting fees for housing loans.

Veterans Benefits

Veterans benefits are questions that all people who have served should seek the information to fully understand their options. Many who have served, while having the option to receive benefits in established Veterans hospitals and facilities, often choose to participate in private facilities. Veterans needing skilled nursing care have the option of receiving the care inside the VA hospital program, or, as with any private citizen, can qualify for Medicaid to pay for those medical needs. Speaking to a person who is certified in VA planning is a critical step in understanding what option is right for you or your loved one.
Source: ABC News

Palliative Care: 10 Facts To Know

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What Is Palliative Care?

Palliative care is an approach that improves the quality of life of patients (adults and children) and their families who are facing problems associated with life-threatening illness. It prevents and relieves suffering through the early identification, correct assessment and treatment of pain and other problems, whether physical, psychosocial or spiritual.

This care is a crucial part of integrated, people-centered health services, at all levels of care: it aims to relieve suffering, whether its cause is cancer, major organ failure, drug-resistant tuberculosis, end-stage chronic illness, extreme birth prematurity or extreme frailty of old age.

Fact 1: Palliative care improves lives

Worldwide, only about 14% of people who need care currently receive it. The quality of life of patients and their families who are facing problems associated with life-threatening illness, whether physical, psychosocial or spiritual are greatly improved by palliative care.

Fact 2: Pushing policy will drive palliative care forward

World Health Assembly resolution 67.19 on strengthening palliative care, adopted in 2014, emphasizes the need to create national care policies, to ensure secure access to opioids for pain relief, training for all health care staff in palliative care, and the integration of palliative care services into existing health care systems.

Fact 3: Most people in need of palliative care are in their own homes

Therefore, the most effective models of palliative care link supervised home care and care at community health centres to hospitals with more palliative care expertise.

Fact 4: Palliative care benefits everyone

Patients during treatment for serious illnesses, not only patients at the end of their lives, can take advantage of what palliative care can offer. For example, it can improve the quality of life of patients receiving radiation therapy for cancer or chemotherapy for cancer or drug-resistant tuberculosis.

Fact 5: Oral immediate-release morphine is an essential palliative medicine

Opioid laws and prescribing regulations must balance the prevention of illegal use of opioids with ensuring accessibility to morphine to relieve moderate and severe pain.

Fact 6: Children have little access to palliative care

They are at a higher risk than adults to face inadequate pain relief. For children, 98% of those needing palliative care live in low- and middle-income countries with almost half of them living in Africa.

Fact 7: Palliative care is “people-centered”

For example, it respects the values and confidentiality of patients, seeks to protect patients and their families from financial hardship due to the illness, and provides emotional support both during the illness and for the bereaved.

Fact 8: Palliative care shows global disparity

Lack of access to palliative care and pain control is one of the largest inequalities in global health. Most people in high-income countries have access, but only a small percentage of people in low- and middle-income countries do. Each year an estimated 40 million people are in need of palliative care, 78% of whom live in low- and middle-income countries.

Fact 9: The need for palliative care has never been greater

It continues to grow with the increase of chronic diseases and people living to an older age.

Fact 10: Integrating home care has multiple benefits

Palliative care that includes home care can improve the quality of life of patients and their families while also saving money for health care systems by reducing unnecessary hospital admissions.

Long Term Care

http://www.who.int/features/factfiles/palliative-care/en/

Home Placed In Massachusetts Trust Protected

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Ability to Use House Placed In Massachusetts Trust Does Not Render Trust Available

Reversing a lower court, Massachusetts’ highest court rules that two Medicaid applicants’ trusts were not available assets even though the applicants retained the right to use the houses that were put into the trusts. Daley v. Secretary of the Executive Office of Health and Human Services (Mass., No. SJC-12200, May 30, 2017) and Nadeau v. Director of the Office of Medicaid (Mass., No. SJC-12205, May 30, 2017).
James and Mary Daley created an irrevocable trust. They conveyed their interest in their condominium to the trust, but retained a life estate in the property. Seven years later, Mr. Daley was admitted to a nursing home and applied for Medicaid benefits. The state denied him benefits after determining that the trust was an available asset. Lionel Nadeau and his wife created an irrevocable trust and transferred their house into the trust. The trust provided that the Nadeaus had the right to use and occupy the house, which they did until Mr. Nadeau entered a nursing home and applied for Medicaid benefits. As with the Daleys, the state considered the trust a countable asset and denied benefits.

The Daleys and the Nadeaus appealed but following hearings, the state ruled that the trusts were available assets because the Daleys and Nadeaus had the right to occupy and use the properties that were in the trusts. In separate rulings, Massachusetts trial courts held that both trusts were available assets. [Daley v. Sudders, Mass. Super. Ct., No. 15–CV–0188–D; Dec. 23, 2015; and Nadeau v.Thorn, Mass. Super. Ct., No. 14-DV-02278C, Dec. 30,2015]; see The ElderLaw Report, March 2016, p. 5.) The Daleys and Nadeaus appealed and the Massachusetts Supreme Judicial decided both cases together.

The Massachusetts Supreme Judicial court reverses, holding that the trusts are not available assets. According to the court, “where a trust grants the use or occupancy of a home to the grantors [as in the Nadeau’s case], it is effectively making a payment to the grantors in the amount of the fair rental value of that property.” The court adds that these payments “do not affect an applicant’s eligibility for Medicaid long-term care benefits, but they may affect how much the applicant is required to contribute to the payment for that care.” In the Daleys’ case, the court rules that because the Daleys hold a life estate, their use of the home is not considered income and “the continued use of the home by the applicant pursuant to his or her life estate interest does not make the remainder interest in the property owned by the trust available to the applicant.”

Maryland elder law attorney Ron M. Landsman joined the briefing and argument. In reaching its conclusion in the Daley case, the court cites the Elder Law section of West’s Massachusetts Practice series, written by Harry S. Margolis and Jeffrey A. Bloom of the Boston firm of Margolis & Bloom, LLP. For the full text of this decision, go to: http://tinyurl.com/elr-Daley3

AARP ranks Rhode Island 32nd among states in meeting long-term care needs

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Source: AARP ranks Rhode Island 32nd among states in meeting long-term care needs

PROVIDENCE, R.I. — Rhode Island ranks 32nd in the nation, and the worst in New England, when it comes to meeting the long-term care needs of older residents and people with disabilities, according to a scorecard released this week by the national nonprofit AARP.

The good news: Rhode Island showed improvement in all but one category.

“The vast majority of older Rhode Islanders want to live independently, at home, as they age — most with the help of unpaid family caregivers,” Kathleen Connell, state director of AARP Rhode Island, said in a statement released Wednesday. “Even facing tight budgets, Rhode Island is making progress to help our older residents achieve that goal. However, this scorecard shows we have more to do, and we need to pick up the pace.”

Rhode Island ranks 22nd nationally “support for family caregivers” and 24th in “quality of life and quality of care.” The state ranks 35th in “effective transitions,″ or how effectively the state transitions residents between nursing homes, hospitals and homes — the only category that showed a decline.

The report — “Picking Up the Pace of Change: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers” — is the third in a series that ranks states overall and on 25 separate indicators in five key areas: affordability and access; choice of setting and provider; quality of life and quality of care; support for family caregivers; and effective transitions between nursing homes, hospitals and homes.

Unpaid family caregivers provide the bulk of care for older Rhode Islanders, in part because the cost of long-term care remains unaffordable for most middle-income families, according to AARP Rhode Island. More than 134,000 Rhode Islanders help care for their aging parents, spouses and other loved ones so they can stay at home. AARP estimates the value of this unpaid care at about $1.78 billion.

“Many [family caregivers] juggle full-time jobs with their caregiving duties,″ Connell said, while “others provide 24/7 care for their loved ones.” Family caregivers “save the state money,″ she said, “by keeping their loved ones out of costly nursing homes – most often paid for Medicaid.″

Rhode Island improved its rank from 50th to 44th in the percentage of Medicaid long-term care dollars for older adults and people with physical disabilities that support care at home and in the community.

The report comes at a time when proposals in Washington are being considered to drastically cut federal Medicaid funding, which Connell said “would threaten these advancements, likely resulting in our most vulnerable citizens losing the lifesaving supports that they count on.″

The scorecard was developed AARP with the support of The Commonwealth Fund and SCAN Foundation.

The AARP Rhode Island has more than 138,000 members age 50 and older in the state.

New England Scorecard Rankings (best to worst):

Vermont: 3

Connecticut: 10

Massachusetts: 11

New Hampshire: 16

Rhode Island: 32

Rhode Island’s scorecard:

Overall: 32

Affordability and Access: 34

Choice of Setting and Provider: 30

Quality of Life & Quality of Care: 24

Effective Transitions: 35

-larditi@providencejournal.com

(401)277-7335

On Twitter: @LynnArditi

Pre-Planning versus Emergency Planning

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Pre-Planning vs. Emergency Planning

This video explains the difference between pre-planning and emergency planning when confronted with planning for long-term care and skilled nursing care and Medicaid qualification.

Posted by Rhode Island Medicaid Planning on Monday, June 5, 2017

Don’t Sell The House In A Panic – Plan Ahead!

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Worried about how you are going to pay for your medical bills? Think the only solution is to sell the house to create the cash that you will need? Don’t make uninformed decisions! There are options available that will allow you to receive the care you need without needing to sell the house.

Whether you need to do emergency planning or if you have the benefit of 5 years of expected health – we have options for you.

We meet with you, discuss your specific facts, goals and concerns, and advise you as to your best legal options.

Don’t panic – call us today for a free consultation.

Matt Leonard