Patti's Blog - Advocate for Elders, People with Disabilities and Their Families

Low Obamacare Premiums to Soften Blow for Those Losing Medicaid

Ganny Belloni
March 16, 2023, 5:44 PM

CMS will take active role during Medicaid eligibility checks

All states required to take 14 months to complete checks

One-third of the millions of individuals expected to lose Medicaid coverage as eligibility checks resume this spring will qualify for Affordable Care Act coverage with low or no premiums, a top Medicaid official said.

The Department of Health and Human Services believes the majority of those whose Medicaid eligibility will be redetermined will remain eligible, and the government is actively collaborating with states to make sure beneficiaries don’t lose coverage because of administrative issues, Daniel Tsai, director of the federal Center for Medicaid and CHIP Services, said Thursday in an interview with reporters

see full article at :

https://news.bloomberglaw.com/health-law-and-business/low-obamacare-premiums-to-soften-blow-for-those-losing-medicaid

#AffordableCareAct #DepartmentofHealthandHumanServices #CenterforMedicaidandCHIPServices #DanielTsai #Medicaid #CMS

Preventing HAIs in long-term care

Excerpt from: McKnight's (click for full article)

 

Preventing the spread of MRSA, CRE and other hospital-acquired infections(HAIs) is quickly becoming a top priority in skilled nursing and long-term care facilities. Caregivers need to be ever vigilant to ensure that hands are washed, gloves are worn, personal protective equipment procedures are followed and a litany of other precautions are taken to protect patients, their families, and themselves. In addition to the human cost, nosocomial infections  in the U.S. add approximately $40,000 in medical costs per patient due to longer hospital stays, readmission, and further treatment.¹

Residents living with diabetes have weakened immune systems that make them more susceptible to MRSA and other antibiotic-resistant infections. Those in skilled nursing and long-term care facilities are especially vulnerable, as this population is prone to developing skin wounds that easily spread bacteria. In fact, 85% of MRSA outbreaks occur in healthcare facilities.

The CDC recommends that facilities pay particular atttention to cross-contamination points--the surfaces touched by an infected patient which become the main vectors for the spread of MRSA, C. diff, and VRE. Studies have shown that a surprisingly high percentage of presumed-clean blood pressure cuffs that are shared among patients [in our facilities] house these organisms …² As a result, the CDC has issued guidelines … recommending the use of single-patient blood pressure cuffs.³

Mental Health Counseling Week and Disability

Excerpt from: Atlantic Highlands Herald (click for full article)

 

Besides having penned this newspaper column about disability since 2002, I'm also a licensed professional counselor and national certified counselor.

Recently, the American Mental Health Counselors Association (AMHCA) sent an email to its membership declaring May 6-12 as "Mental Health Counseling Week" and urging all AMHCA members to "set aside time during (the week) to participate in local activities to promote and reinforce the importance of mental health."

So today I'm tossing in my two cents. A disproportional percentage of people with disabilities also have a mental illness.

Overall, America is becoming more "disabled" as its population skews older and medical science becomes more skilled at preserving the lives of people with medical issues. The number of people claiming disability benefits is skyrocketing. The federal government generally determines a person has a disability when that person has a significant impairment in any major life function, such as walking, seeing or thinking.

Phone applications for medicine

 

Doctors’ Errors: They Happen More Than You Think (And Can Hurt You)

Excerpt from: AARP (click for full article)

 

Until it happened to him, Itzhak Brook, a pediatric infectious disease specialist at Georgetown University School of Medicine, didn’t think much about the problem of misdiagnosis.

That was before doctors at a Maryland hospital repeatedly told Brook his throat pain was the result of acid reflux, not cancer. The correct diagnosis was made by an astute resident who found the tumor  —  the size of a peach pit  —  using a simple procedure that the experienced head and neck surgeons who regularly examined Brook never tried. Because the cancer had grown undetected for seven months, Brook was forced to undergo surgery to remove his voice box, a procedure that has left him speaking in a whisper. He believes that might not have been necessary had the cancer been found earlier.

“I consider myself lucky to be alive,” said Brook, now 72, of the 2006 ordeal, which he described at a recent international conference on diagnostic mistakes held in Baltimore. A physician for 40 years, Brook said he was “really shocked” by his misdiagnosis.

Travel Insurer Knows Which Question To Ask Doctor In Order To Deny Claim

Excerpt from: The Consumerist (click for full article)

Patti's comment: I have had personal experiences like this, as have many of my clients, so be careful folks!

 

When you’re buying a non-refundable plane ticket, it can be very tempting to fork over the few extra dollars to pay for travel insurance so that you’ll be able to get your money back in the case of an emergency like a medical crisis. But as easy as it is to click on that box and sign up for the plan, the insurance companies don’t always make it easy when it comes time to file a claim.

Take the example in today’s L.A. Times of a California woman who had to cancel her plans to visit Washington, D.C., in December after she began experiencing shortness of breath and her doctor advised her not to fly. Luckily, she’d paid $29.33 for a travel insurance policy so she’d be able to get her $451 airfare refunded.

Not exactly.

See, this particular travel insurance policy has an exception for cancellations due to pre-existing medical conditions, and the insurer eventually determined that the passenger’s cancellation fell under this category.

Misuse and Abuse of ADHD Meds among college students

Excerpt from: Sharp Brains (click for full article)

 

The mis­use and abuse of pre­scrip­tion med­ica­tion is a grow­ing con­cern. I remem­ber speak­ing with col­leagues 15–20 years ago as reports about the non­med­ical use of stim­u­lant med­ica­tions used to treat ADHD (non­med­ical use is defined as use by indi­vid­u­als with­out a pre­scrip­tion) were first appear­ing in the media. At the time, these were gen­er­ally thought to be iso­lated inci­dents that were being over-dramatized in the press.

It has become clear, how­ever, that this is not the case today and that the non­med­ical use of ADHD meds, as well as mis­use by indi­vid­u­als for whom med­ica­tion is pre­scribed, is an impor­tant prob­lem. At the link above is a brief overview and sum­mary of research on these issues.

What defines a medical inquiry?

Excerpt from: NWI.com (click for full article)

 

One given principle of the Americans With Disabilities Act provides that employee medical information obtained from “medical examinations and inquiries” must be treated as a confidential medical record. The issue is what is an inquiry?

Consider these facts: an employee failed to report to work. The employer sent the employee an email, asking him what he was doing. The employee replied with an email stating he had a severe migraine.

Shortly thereafter, the employee quit his job. Future employers contacted the former employer and asked for a reference. The former employer responded by saying that the ex-employee had “medical conditions” involving migraines, but that this wasn’t an issue in his job performance.

The Equal Employment Opportunity Commission filed suit against the former employer, claiming that its disclosure of the medical condition was a per se violation of the ADA. The employer defended by arguing that its receipt of the employee’s medical information, in the email the employee initiated, was not obtained from a medical inquiry.

The court ruled for the employer. It rejected the EEOC’s argument that any communication between an employer and an employee, initiated by the employer, which results in the disclosure of medical information is an “inquiry.”

Majority Of Personal Bankruptcies The Fault Of Medical Costs

Excerpt from: Huffington Post (click for full article)

 

You may have already read or heard about Steven Brill's excellent, long article in Time magazine, called "Bitter Pill: Why Medical Bills Are Killing Us." If you think it doesn't concern you, don't be so sure.

Read the whole story at The New York Review of Books

Dementia passes Cancer and heart disease as most expensive medical condition

Excerpt from: News Talk Radio (click for full article)

 

The average cost of dealing with a family member with Alzheimer’s or some form of dementia is now at $51,000 yearly.

Overall, the New England Journal of Medicine says Americans spent around $215 billion on dementia in 2010.

The biggest part of that cost, around 84%, is said to be long term care such as a nursing home or care of a patient in their residence.

One of the biggest factors in the growth of dementia is an aging population.

Some estimates indicate that the cost of medical issues that have to do with age will cost each American nearly 80% more by 2040.