October 3, 2007

CARIE Policy Update and Meeting Announcement

Quote of the Month
“Brick Walls are there for a reason. They let us prove how badly we want things.” – Dr. Randy Pausch

Medicare Part D Low Income Subsidy
The Centers for Medicare & Medicaid Services (CMS) announced the elimination of the 2008 late enrollment penalty for any beneficiary eligible for the Medicare Part D Low Income Subsidy (LIS). Medicare beneficiaries who qualify for the LIS may enroll in a Medicare prescription drug plan with no penalty through December 31, 2008.

On September 17, 2007, CMS began mailing letters on grey colored paper to about 447,000 current Medicare Part D LIS recipients who will not automatically continue to receive the subsidy in 2008 unless they either re-qualify for Medicaid or SSI, or apply for the LIS through the Social Security Administration (SSA). This is known as the "re-deeming" process. Beneficiaries with “deemed” status will automatically qualify for LIS because they were identified as being dually eligible for Medicare and Medicaid, in the Medicare Savings Program (MSP), or receiving Supplemental Security Income (SSI). CMS has posted a fact sheet, “Low Income Subsidy (LIS) Redeeming Questions and Answers,” and other information on its Limited Income and Resources webpage.  The National Senior Citizens Law Center (NSCLC) has a “Low Income Subsidy Tools” webpage that has more information about the re-deeming process including a new guide, “LIS: Redetermination and Redeeming.” 

The SSA conducts a process called “redetermination” which is similar to the redeeming process conducted by CMS. SSA sent letters to 500,000 Medicare beneficiaries in September requiring that they complete a form and mail it back to SSA within 30 days in a pre-paid envelope. (Beneficiaries can request a one-time 30 day extension from SSA to complete the form.)  However, beneficiaries who do not complete and submit the form within 30 days will lose their LIS after December 31, 2007.  Last year SSA sent out redetermination forms but beneficiaries who did not return their forms did not lose their LIS. Especially since there were no consequences for inaction last year, advocates fear these individuals will not respond again this year and will lose their LIS.  A copy of the letter and form are available on SSA’s website. 

Other helpful LIS resources include the Center for Medicare Advocacy’s “Updates for People Eligible for the Part D Low Income Subsidy” and the Pennsylvania Health Law Project’s LIS brochure.

Stop PA's Senate Bill 9
Community Legal Services is seeking help with an advocacy campaign to help defeat Senate Bill 9. Senate Bill 9, “the Proof of Citizenship for Receipt of Public Benefits Act,” was introduced by Senate Pro Tempore Joseph Scarnati and may be voted upon this fall. Senate Bill 9 would require anyone applying for public benefits in Pennsylvania to provide government-issued ID and sign an affidavit that they are US citizens or eligible legal immigrants in order to get public benefits or help from a private agency that gets state funds. Applicants signing the affidavit would have their status verified by the Federal Systematic Alien Verification of Entitlement Program.

The problem is that undocumented immigrants are already prohibited from all major public benefit programs in Pennsylvania. The people who will be hurt by this bill are US citizens and eligible legal immigrants. They already must prove their identity when applying for public benefits; however, SB 9 would require that they provide “government-issued” ID. For example, older adults applying for a Nursing Home grant would be required to provide “government-issued” ID. It is estimated that 18% of older adults do not have government-issued ID and it can take them months to acquire this ID. Advocates are asked to contact their state senator to ask that they vote against Senate Bill 9. Click here to identify your state Senator and contact information.

The Reliability of Hospital Comparison Websites 
According to an article published in the Archives of Surgery, six hospital comparison websites were analyzed and were all found to be incomplete or inappropriate. None of the websites had data that was less than twelve months old and most data was two or more years old. Among the websites compared was CMS’ “Hospital Compare.” For more information, please read this article from Medical News Today.

In Pennsylvania, there is a more reliable source of hospital comparison information provided by the Pennsylvania Health Care Cost Containment Council. A recent report covers 51 treatments and surgical procedures provided by Pennsylvania's hospitals including patient outcome results such as mortality, readmission, and length of stay data, as well as hospital charges.     

Just the Links.....
The following are links to potential resources or documents of interest:

• The Pennsylvania Senate now has a live online video feed of Senate floor proceedings.
• CMS provided state Medicaid directors with information about using “cash” for Medicaid self-directed personal care services.
• The US Treasury Department released an issue brief, “Social Security Reform: The Nature of the Problem.” This is the first in a series of issue briefs the Treasury Department plans to release about Social Security.
• The Senate unanimously passed a mental health parity bill, S. 558 and the House has a similar bill, H.R. 1424, with 270 cosponsors. The Congressional Budget Office released a report on H.R. 1424.
• CMS announced its Medicare premiums and deductibles for 2008.  
• MetLife released survey results about the costs of adult day centers and home health care rates. The average adult day center rate is $61/day and the average rate for a home health aide is $19/hour.
• According to a recent study, poorer quality of nursing home care is linked to racial segregation and blacks are more likely than whites to reside in poor performing nursing homes.
• The National Center on Elder Abuse has reorganized and has a new website.
• The US Department of Labor has issued a new report, “The Family and Medical Leave Act: A Report on the Request for Information.”
• The Medicare Rights Center has posted a report, “Informed Choice: The Case for Standardizing and Simplifying Medicare Private Health Plans.”
• Rand Health has posted a summary of research related to Medicare Part D, “A Look Inside the Doughnut Hole” and a fact sheet, “A Systematic Review of the Adverse Effects of Prescription Drug Cost Sharing.”
• The Population Research Bureau released research highlights, “Assessing the Fiscal Impact of Aging.”
• Quality Insights of Pennsylvania has posted new hospital appeals discharge forms and a PowerPoint presentation, “Hospital Discharge Appeal Rights.”  

The "Best Lecture Ever"
Dr. Randy Pausch, a computer-science professor at Carnegie Mellon University, recently gave an inspiring lecture to 400 students and colleagues. This was Dr. Pausch’s last lecture since he has pancreatic cancer and only a few months left to live. Because of the power of the internet, Dr. Pausch’s one-hour lecture has been viewed by millions and he has heard from thousands of people who told him how his speech had a profound impact on their lives. Hundreds of bloggers have written essays about the speech with headlines like “Best Lecture Ever.” For those who only have a few minutes to spare, click here for excerpts from the lecture or go to Dr. Pausch’s website for a transcript and other media coverage links.

CARIE News 
CARIE is pleased to announce that Sarah Duncan-Wisniewski has joined the CARIE team. Sarah is working part-time as a CARIE LINE Advocate. Welcome Sarah!

October Meeting Announcement
The Dorothy S. Washburn Legislative Committee meeting will be held on October 4, 2007. Click here for the agenda.  Please feel welcome to join us. LaSalle’s Nonprofit Center will be conducting a workshop at CARIE on November 8, 2007 so the November Legislative Committee meeting is cancelled. There is a fee for the workshop and registration must go through LaSalle's Nonprofit Center.  As always, don't hesitate to contact me if you have any questions.
Thanks,
Kathy