Saturday, January 31, 2015

Bill Introduced to Repeal PA Filial Support Law

Pennsylvania’s filial support law can make children financially responsible for their aging parents care costs. The law allows nursing homes and other care providers to sue children to recover unpaid care related expenses. It also allows for lawsuits by the state Department of Human Services.  
Nursing homes, in particular, have been using the law to sue children for their parent’s unpaid bills. For example, in the recent case of HCRA v. Pittas a son was held liable for over $92,000 of his mother’s past due nursing home bills. The son was not accused of any wrongdoing. The son was held liable for the debt solely because he was his mother’s son and had some ability to pay.  
Current Pennsylvania law provides that children have the responsibility to care for and maintain or financially assist their indigent parent. 23 Pa. C.S.A. §§ 4601-4606. Likewise, parents have the responsibility to care for and maintain or financially assist their indigent adult children. This is sometimes referred to as “filial support.” The word “filial” means “pertaining to, or befitting a son or daughter.”  
Pennsylvania’s filial support law has been criticized as being a vestige of colonial era poor laws that should have no place in our present society. Many see the law as being fundamentally unfair and counterproductive. It does not support older adults. It is injurious to family relationships and may lead to the denial of needed care. 
A bill has been introduced in the Pennsylvania General Assembly to totally repeal Pennsylvania’s filial support law. HB 242 (2015) was introduced by Representative Anthony DeLuca with bipartisan co-sponsorship by the following Representatives: THOMASLONGIETTID.COSTADUNBARSCHLOSSBERGKOTIKMcNEILLGAINEYD. MILLERCOHENGIBBONS and WATSON.
On January 28th HB 242 was referred to the House Judiciary Committee for consideration. Chair of that committee is Representative Ron Marsico.
If you believe that children should not be held financial responsible for their parent’s health and personal care costs, you might want to let your representative know your feelings. You can find the name and contact information for your representative here.
More Information:

Saturday, January 24, 2015

Moving your Medicare Appeal to the Front of the Line

Medicare beneficiaries continue to be erroneously denied the coverage to which they are entitled. Despite court rulings and regulations to the contrary we are finding that many nursing facilities continue to deny residents Medicare payment based on the discredited “improvement standard.” 
Under the law, Medicare benefits should depend on whether the patient can improve, but on whether skilled care is required and whether the services themselves are reasonable and necessary. See Downfall of the Medicare Improvement Requirement will Benefit Many.
Observation Status problems are also a growing concern for seniors who receive hospital treatment. If you need nursing home care after your hospitalization, it is very important that your hospitalization was an “inpatient admission.” (Medicare will only cover nursing home care after a 3-day inpatient hospital stay.) See Beware of Hospital "Observation Status."  
Medicare beneficiaries who are wrongly denied coverage have a right to appeal. But, until recently, pending appeals could be sunk for years in a Medicare bureaucratic bog. 
But there is some good news. A recent article written by Susan Jaffe and originally published by Kaiser Health News notes that while the number of appeals has been growing, wait times have been cut dramatically for Medicare beneficiaries.
Here is that article (reproduced with permission). 
Seniors’ Wait For A Medicare Appeal Is Cut In Half 
The federal office responsible for appeals for Medicare coverage has cut in half the waiting time for beneficiaries who are requesting a hearing before a judge.
The progress follows an announcement last January that officials were going to work through a crushing backlog by moving beneficiaries to the front of the line and suspending hearings on cases from hospitals, doctors and other providers for at least two years.

The Office of Medicare Hearings and Appeals (OMHA) has decided most of the 5,162 cases filed by beneficiaries in the fiscal year ending Sept. 30, plus 1,535 older cases, according to statistics provided to Kaiser Health News.
That’s a dramatic change from the year before, when a third of beneficiary cases (1,493) were not decided and nearly half (1,705) of the 2012 cases also were unresolved.
Still, about 900,000 appeals are awaiting decisions, with most filed by hospitals, nursing homes, medical device suppliers and other health care providers, said Jason Green, OMHA’s program and policy director. The wait times for health providers’ cases have doubled since last year, and are nearly four times longer than the processing time for beneficiary appeals.
Hospitals file more appeals than any other provider. The single largest reason is the increasing number of Medicare payment denials for patients who have been admitted to the hospital but whom auditors later say should have been kept instead for observation care, a status that reduces payments.
Seniors also have long complained about observation care because Medicare doesn’t cover follow-up nursing home care for observation patients.
The rise in beneficiary appeal decisions is a direct result of the “beneficiary-first” policy Chief Judge Nancy Griswold announced last January, said Green. The temporary measure will remain in place as long as there is a backlog, he added.
Since then, beneficiaries have waited 113 days on average for a hearing, compared to 235 days the year before, said Green. This includes appeals from beneficiaries in traditional Medicare and private Medicare Advantage insurance plans. It’s a big improvement but still not in compliance with the federal requirement that an appeal be decided within 90 days after a request for a hearing.
“We are striving toward that 90-day mark,” said Green, who expects the beneficiary appeals backlog will continue to shrink next year.
Reaching the Office of Medicare Hearings and Appeals (OMHA) is the third of four stages in the appeals process and the first opportunity for Medicare beneficiaries or health care providers to present their case before a judge. The odds of winning an appeal at the third stage are far better than at the previous levels, which involve only a review of the case files, the Health and Human Services inspector general has found.
But seniors seeking top priority treatment, must identify themselves by addressing their appeal to an OMHA office in Cleveland and writing “Attn: Beneficiary Mail Stop” on the envelope. Griswold announced the new mail address last February, and it is part of the instructions beneficiaries receive when their appeal is denied at the second level.
Beneficiary appeals filed before the new policy was established may be languishing in the backlog pile until officials find them.
“Beneficiaries can help us to help them get to the front of the line,” Griswold said at a meeting in October. She urged those beneficiaries to write to her office using the special mailing address or to call her office at 855-556-8475. 
This article was written by was produced by Kaiser Health News with support from The SCAN Foundation and originally published on December 23, 2014. Kaiser Health News (KHN) is a nonprofit national health policy news service.  
Other Resources, Claims & appeals
Center for Medicare Advocacy, Home Health

Monday, January 19, 2015

A Best Law Firm

We recently received notice that our law firm, Marshall, Parker and Weber, has been named to the list of best elder law firms in Pennsylvania for 2015. The award is made by US News Best Lawyers®. We were also named to this list last year. [Here is a link to information on the selection method:].  

I was individually recognized as one of the best elder law attorneys in the Commonwealth for 2015.
There are many fine elder law attorneys in Pennsylvania. We understand that being named to the top tier of elder law firms (as one of only 8 law firms in the state) is not just an honor – it’s a responsibility.
It is special to me to have received these recognitions this year – 2015 – because this year will see the 35th anniversary of the founding of Marshall, Parker and Weber. Back in 1980 I had no idea what would grow from the seed I was planting. How remarkable it has been to watch it develop into one of the most respected elder law and estate planning law firms in Pennsylvania. It is reason to celebrate. 
2015 is also the year when I reach age 70. This means I have reached the government defined maximum “retirement age” and have to start drawing on my Social Security and retirement plan benefits. This makes this feel like a watershed year.
As an elder law attorney I’ve helped so many clients plan for aging. And now I have arrived at an age where my own retirement plan is set to begin. I’ve become my own client. 
So, this year is a time of some culmination and much reflection for me. I realize now how fortunate I’ve been in my life and I say a prayer of thanks every day. I’ve had a wonderful loving family, a good education, and decent health. And I was particularly fortunate to have found a career path in elder law that I have loved and which has brought satisfaction and meaning to my life.
The occasional peer recognition, like Best Law Firms, is a small (but appreciated) bonus. Especially this year. 
I hope you will help us celebrate our 35th anniversary.  
Further Information 
Join us for Marshall, Parker and Weber’s 19th Annual Professional Update on May 6 or 7, 2015. Click here for more information: 

Saturday, January 17, 2015

Pennsylvania Aging Related Leaders Named

Governor–elect Tom Wolf has announced that he has chosen Teresa Osborne, who is the executive director of the Luzerne/Wyoming Counties Area Agency on Aging (AAA), to be secretary of the Pennsylvania Department of Aging. The Governor-elect also announced that he has chosen Ted Dallas, currently the secretary of the Maryland Department of Human Resources, to be his secretary of the Department of Human Services (formerly called the Department of Public Welfare).

Here is a link to the announcement of Ms. Osborne’s selection. And here is a link to the announcement regarding Mr. Dallas.

Teresa Osborne seems like an excellent choice to me. I’ve known her for years. She served as executive director of the Lackawanna County AAA before taking on the Luzerne County position. (My law firm has offices in both those counties). She is very knowledgeable, hard-working, smart, and an ardent advocate. Just what we need at the Department of Aging during challenging times.

The appointments are subject to approval by the Pennsylvania Senate.

Both of the Secretary-designates will need to work closely with the Legislature. Here is the current list of the 2015 chairs (Republican) and minority leaders (Democrat) of several legislative committees related to aging.

Senate Aging and Youth Committee:
Republican: Senator Michelle Brooks
Democrat: Senator Arthur Haywood
Committee Members listing: here

Senate Public Health and Welfare committee:
Republican: Senator Pat Vance
Democrat: Senator Shirley Kitchen
Committee Members listing: here

House Aging and Older Adult Services Committee:
Republican: Rep. Tim Hennessey, 26th Legislative District, Chester and Montgomery counties.
Democrat: Rep. Steve Samuelson, 135th Legislative District, Lehigh and Northampton counties.
Committee Members listing: here 

House Health Committee:
Republican: Rep. Matt Baker, 68th Legislative District, Bradford, Potter and Tioga counties.
Democrat: Rep. Florindo (Flo) Fabrizio, 2nd Legislative District, Erie County.
Committee Members listing: here 

Human Services Committee:
Republican: Rep. Gene DiGirolamo, 18th Legislative District, Bucks County.
Democrat: Rep. Angel Cruz, 180th Legislative District, Philadelphia County.
Committee Members listing: here

More information about the 2015-2016 PA General Assembly is available at: