You are no doubt encountering questions and challenges right now related to everything from employment to health insurance to online bill-paying to gaining access to your loved ones in health care facilities.Here we compile some really useful sources and we hope you’ll take a few minutes to click through to find information you can use for your situation.
Resources from NJ Department of Health: https://www.nj.gov/health/cd/topics/covid2019_dashboard.shtml
The latest on court closings and procedures: https://njcourts.gov/
Resources from the NJ Bar Association for lawyers and clients: https://njsbf.org/contact-us/covid-19-information-resource-page/
Resources from the IRS: https://www.irs.gov/coronavirus
Resources from the Social Security Administration: https://www.ssa.gov/coronavirus/
Resources from Medicare: https://www.medicare.gov/medicare-coronavirus
Easier path into rehab on Medicare Part A now: https://blog.finkrosnerershow-levenberg.com/elder-law-news/3-night-stay-requirement-waived-for-medicare-part-a-subacute-benefits/
Stay safe, stay healthy. We’re open for business and here to assist you.
Call for a Phone Appointment …… 732-382-6070
Medicare Part A covers post-hospitalization, subacute skilled care and rehabilitation benefits for individuals who were admitted to the hospital and remained as inpatients for at least three overnights. Upon discharge to a subacute facility with a need for ongoing skilled nursing or rehabilitative services, Medicare would cover up to 100 days of treatment including the room & board costs, subject to co-payments and deductibles. In other posts, we have written about some of the issues that would come up for patients receiving such benefits.
In light of the exigencies caused by COVID-19 and the urgent need to transfer patients from hospitals to subacute rehabilitation facilities, Medicare has waived the three-overnight requirement for people in the hospital to get to subacute rehab. There have been demonstration projects around the country for several years involving waivers of the 3-day stay requirement. Medicare 3 day waiver. The March 13th announcement by the CMS Administrator specifies that ” Therefore, SNF care without a 3-day inpatient hospital stay will be covered for beneficiaries who experience dislocations or are otherwise affected by the emergency, such as those who are (1) evacuated from a nursing home in the emergency area, (2) discharged from a hospital (in the emergency or receiving locations) in order to provide care to more seriously ill patients, or (3) need SNF care as a result of the emergency, regardless of whether that individual was in a hospital or nursing home prior to the emergency. In addition, we will recognize special circumstances for certain beneficiaries who, prior to the current emergency, had either begun or were ready to begin the process of ending their spell of illness after utilizing all of their available SNF benefit days.” CMS’ 2020 SNF secn 1812f waiver
The patient and their advocate will need to be proactive as always in working with the physician and the SNF assessing staff to develop a treatment plan that provides the fullest possible range of services to meet the needs of the patients. Keep in mind that “failure to progress” is not the sole criteria for continued Medicare coverage for subacute care. However there is an increasing trend by Medicare insurance intermediaries to pressure the facilities to terminate coverage after just a few weeks. What do advocates need to do? Be vigilant, be vocal, be aware. Make sure that the patient you are assisting has signed HIPPA releases to enable you to access their protected health information and talk with the personnel on the team. Be vigilant, be vocal, be there.
The State of New Jersey Department of Human Services has announced some initiatives designed to help assure continuity of care, access to medicine and nutrition assistance, for individuals who are dependent on programs such as SNAP, group homes, charity medical care, MLTSS home care and services in certain DDD-funded programs. As always, the real test will be in the details for how these initiatives will be administered, but many of the ideas sound great. Some of the efforts that were announced through a press release on the 18th are these:
“Cash, Shelter and Food Assistance
- Automatically extending for 60 days WorkFirst New Jersey cash assistance to individuals whose case is up for renewal in March or April;
- Extending all Emergency Assistance cases through April 30;
- Deeming the current state of emergency as a good cause exemption for the work requirements in WorkFirst New Jersey and SNAP and suspending all adverse actions for non-compliance;
- Covering COVID-19 testing, visits for testing, and testing-related services at no cost;
- Waiving costs for COVID-19 testing, visits for testing, and testing-related services in the Children’s Health Insurance Program (CHIP);
- Covering 90-day supplies of prescriptions for maintenance medications and early refills of prescriptions in Medicaid and CHIP; and
- Directing hospitals to waive cost sharing for uninsured individuals who are eligible for charity care for medically necessary testing and testing-related services for the COVID-19 virus.
“Supporting Older Residents
- Mobilizing nurse care managers at Medicaid health plans to call high risk populations to identify and address their critical needs including supplies such as durable medical equipment and food;
- Allowing older residents receiving prescription drugs through Medicaid or the state prescription drug assistance program (PAAD and Senior Gold) to refill their prescriptions early and receive 90-day supplies of maintenance medications;
- Working with our county partners to ensure that those receiving home-delivered meals continue to have access to food;
“For those receiving DDD services,
- Temporarily closing congregate day programs for individuals with intellectual and developmental disabilities and supporting this transition;
- Providing flexibility to families to quickly hire workers and working closely with program providers and direct support professionals during the closure; ……. “
Tremendous partnership efforts will be needed across all sectors of government and society to take care of our most vulnerable citizens at this difficult time. Hopefully the DHS will focus on flexibility and practicality, minimize red tape and streamline the steps it takes to accomplish these laudable goals.
Call us for help with your urgent elder care problems ………… 732-382-6070
Medicare Part B generally covers medically necessary outpatient testing for beneficiaries. CMS has recently advised that if testing is ordered by the patient’s physician and the test is performed on or after February 4, 2020, it will be a covered service under Medicare Part B. Read more here.
The Centers for Medicare and Medicaid Services is issuing fact sheets and alerts that address corona virus-related concerns raised by Medicare beneficiaries as well as health care providers. Some of them are: guidance to home health care providers — anyone who hires a home care provider might want to study this and share it with their employee — expanded tele-health services to enable people to contact professionals for advice by phone; and specific guidance for specific health care settings such as nursing homes or dialysis centers.
The Center for Medicare Advocacy (CMA) is an excellent source for updates about Medicare and for advocacy on legal problems with Medicare coverage that are encountered by enrollees. Another great source of help can be found at your local SHIP office — the State Health Insurance Assistance Program (SHIP).
Call us for help with your elder care law problems …… 732-382-6070