Tag: elder law attorney

Medicare Wants the Power to Ban Certain Doctors

While the main focus of Medicare has historically been to provide affordable and accessible medications to seniors, its focus has recently changed. Early this January, The U.S. Centers for Medicare and Medicaid Services (CMS) announced a proposed rule that would bring significant changes to the federal agencies.

The most notable change offered by the proposal is the agency’s new authority to kick out physicians and other providers who engage in abusive prescribing. It could also take such action if providers’ licenses have been suspended or revoked by state regulators or if they were restricted from prescribing painkillers and other controlled substances.

Additionally, the agency will tighten a loophole that has allowed doctors to prescribe to patients in the drug program (known as Part D) even when they were not officially enrolled with Medicare. Under the new rules, doctors and other providers must formally enroll if they want to write prescriptions to the 36 million people in Part D. This requires them to verify their credentials and disclose professional discipline and criminal history. Continue reading “Medicare Wants the Power to Ban Certain Doctors”

New York City Settles Allegations of False Medicaid Claims

The case of Ohlmeyer ex rel. United States of America v. City of New York, a whistleblower action brought by the federal government against the city of New York has been settled. The 2012 complaint accused the city’s education department of submitting false claims to Medicaid for counseling services to special education students, and as of January 2014, New York City has agreed to pay $1.37 million in an official settlement.

The complaint, charged that New York City’s Department of Education (DOE) knowingly billed Medicaid for psychological counseling services for individual special education students who did not receive two monthly counseling session, the minimum number required for payment, between 2001 to 2004.

Continue reading “New York City Settles Allegations of False Medicaid Claims”

Medicaid vs. Medicare 101

Although Medicaid and Medicare provide essential services for our loved ones and thousands of Americans, many people either do not know the specifics of each program or simply do not know the difference. Well not anymore! Provided below are the basics everyone should know when dealing with these two aid programs and a basic layout of their differing eligibility requirements, coverage, and funding.

Medicare

Medicare is a federally funded and administered program that provides health insurance for individuals older the age of 65, individuals with disabilities, or individuals with End-Stage Renal Disease (ESRD). Its coverage includes: inpatient services from a hospital or nursing facility, outpatient services, doctor visits, and preventive care, prescription drug costs, or a combination of these services. Most seniors are automatically enrolled when they turn 65, yet those that are disabled are required to contact their local Medicaid office if interested in being enrolled, however cost is not distinguished by qualifying factors but rather is the cost depends on the “level of coverage” assessed.

Medicaid

Medicaid is a federal and state program that is administrated by the state government with the purpose of providing coverage for low-income families. Its coverage includes: hospital and nursing care, certified pediatric and nurse practitioner services, access to federally qualified centers, as well as access to rural health clinic or birth centers licensed by the family’s state. All of those who wish to receive Medicaid benefits must apply within their state office in order to become eligible and costs depend on the income of each family.

Can A Person Qualify for Both Medicare and Medicaid in New York?

Individuals may be dually eligible for both programs. In many of these cases, Medicaid will cover Medicare premiums or co payments for the services covered under Medicare. This allows for effective and comprehensive health coverage.

Contact an Attorney

If you believe you qualify for Medicare or Medicaid and wish to receive benefits, or if you have been previously denied coverage, contact an experienced New York Elder Law Attorney. A skilled attorney can analyze your situation, discuss your options with you, and help ensure your legal rights are protected.

A Living Will vs. A Healthcare Proxy

A Living Will is often confused with a Healthcare Proxy and vice versa by many individuals. Although both provide advance directives regarding medical decisions, they both are separate documents with distinct features and purposes.

It is vital to become aware of these terms, what they mean, and the impact both documents can have on your life and the lives of your loved ones. Get informed and ensure that your legal rights are protected.

A Living Will

A Living Will is a written statement of an individual’s wishes regarding medical treatment. This document is created to define a person’s specific plan as to how their health care will be handled if they are gravely ill or incapacitated in the hospital. The primary issue to be determined in a Living Will is whether a person wishes to be put on life support, and what type of life-preserving measures should be taken.

A Living Will is vitally important not only for the ill person, but for the family. Without a Living Will, a physician may call upon the family members to make very difficult judgment calls. These types of matters have been increasingly more common with advancements in medical science, and the increased ability to extend life.

Living Wills give detailed instructions regarding medical treatment if an individual is in a persistent vegetative state, in a coma, or otherwise unable to communicate how she wants his/her medical treatment handled. Perhaps a person does not believe in being kept alive by artificial means, particularly if there is no hope of recovery. A Living Will stating this fact would give this person control over their own health care when they are unable to express their own wishes.

A Healthcare Proxy

A Healthcare Proxy varies from a Living Will in that a Health Care Proxy appoints a particular person to speak on your behalf regarding medical decisions, if you are in a situation where you can’t make them yourself. The idea behind a Health Care Proxy is that someone makes the decisions you would have made, had you been able to do so.

You must choose your proxy thoughtfully since he/she will be acting on your behalf. After appointing your proxy, it is extremely important to discuss your wishes with them about your medical care, including resuscitation, artificial nutrition and hydration and personal goals for quality of life. Knowledge of your wishes will help guide the decisions your proxy will have to make with your medical team. Knowing that any decisions made are based on your personal values and wishes will be a comfort to family and friends during a stressful time.

Contact an Attorney

If you become unable to direct your own medical care because of illness, an accident, or advanced age, the right legal documents are your lifeline. When you don’t write down your wishes about the kinds of medical treatment you do or don’t want to receive and name someone you trust to oversee your care, these important matters can be placed in the hands of estranged family members, doctors, or sometimes even judges, who may know very little about what you would prefer. In order to ensure you are protected, contact an experienced attorney today.

Recognizing Signs of Elder Abuse in a Loved One

Many senior citizens who are too frail and vulnerable have become victims of elder abuse at the expense of strangers, trusted caregivers and even friends and family members. When one thinks of elder abuse, they think of physical abuse, but it goes beyond that.

Elder abuse takes many forms: sexual abuse (non-consensual sex), willful neglect (failing to provide food, shelter, healthcare or protection for a vulnerable patient), exploitation (stealing, misusing or concealing the seniors’ funds, property or assets for someone else’s gain), abandonment (leaving seniors by themselves without proper care), emotional abuse (verbal threats, humiliation and intimidation) and self-neglect (the failure of a person to perform essential, self-care tasks that may result in a threat of his/her own health or safety).

Signs of elder abuse include bruises, pressure marks and abrasions on the skin; broken bones; unexplained withdrawal from normal activities; depression; sudden changes in their financial situation; bedsores; poor hygiene; unusual weight loss; use of threatening behavior by a spouse; strained or tense situations and frequent arguments between the patient and caregiver.

Elder abuse came into the national spotlight in 2011 when legendary actor Mickey Rooney was granted court protection from his stepson and stepdaughter who he claims abused him, verbally, emotionally and financially. Mr. Rooney also accused his stepchildren of denying him food and medicine.

According to the American Psychological Association, an estimated 2.1 million senior citizens suffer some form of elder abuse. The National Elder Abuse Center report that 21% of elder abuse cases are self-abuse and financial abuse. If you suspect that an elderly loved one may be a victim of elder abuse, it is recommended that you call the authorities and contact us at Tanya Hobson-Williams, P.C..

Testimonials

“I want to take this time to thank Tanya and Keith for their professionalism and their ability to keep me calm during this process. Tanya was very helpful in explaining the whole guardianship process and my next steps. Despite my numerous emails, I never felt ignored or that they were growing weary of me. Even after being granted guardianship when I had an issue with the bank releasing money Tanya stayed calm and found a way to get what I was entitled to. I hope I never need to do this again but if I do, I will definitely come back to Tanya and her team. Thank you Thank you Thank you. Love from Bermuda.”

-K. Durham.
(An attorney in Bermuda transferring a Bermudian guardianship to NY)

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