How will the newly passed Health Care Reform Bill affect my Medicare Insurance?

Ask the Doctor
Leslee B. Cochrane, MD.
Medical Director

Ramona Visiting Nurse Association and Hospice

Question: How will the newly passed Health Care Reform Bill affect my Medicare Insurance?

Many patients are asking the same question; but because the Health Care Bill is over 2,000 pages long it will take some time to fully understand its impact on Medicare. Effective in 2010, the new law will help to decrease the cost of Medicare prescriptions by providing a $250.00 payment to help those caught in the “donut hole” of their deductible. In 2011, preventative care including annual check-ups will also be covered. While these changes are laudable, there is much to be concerned about including the more than $450 Billion in cuts to Medicare funding over the next decade.

In a recent poll conducted by Investors Business Daily, 65% of doctors surveyed opposed the health care plan and 71% did not believe that the plan would be able to provide better care at lower cost as promised. Additionally, 45% of the doctors surveyed said they would consider early retirement or quit medicine altogether if the health plan passed. This is particularly concerning due to projections of significant physician shortages over the next ten years.

The programs most affected by the Medicare cuts will be Medicare Choice programs such as Medicare HMO plans. The cuts will also include over 6.8 Billion dollars in cuts to Hospice and decreased payments for Home Health Services as well. The recent 21% cut in Medicare payments to physicians that took effect April 1st is one of many complex issues which will need to be resolved. Although there are plans to reverse this pay cut, many doctors are closing their practices to Medicare patients because of low payments and the added hassles of government paperwork.

The present Health Care Bill does not address the pending physician shortage or the wave of retiring baby boomers which will nearly double the number of Medicare patients over the next 30 years. Add to this the decreasing number of doctors willing to accept Medicare and the 32 million newly insured patients who will be competing for limited resources and you can see that having insurance does not guarantee easy access to a doctor. Patients planning to retire soon should begin planning early in order to locate a physician who will accept Medicare. If you have questions regarding your options under Medicare you can call the HELP line at 1-888-983-5337, or visit the website at http://www.help4elders.info .

If you would like to submit a question please contact Jennifer Trebler at jtrebler@ramonavna.org.

Recognizing and Preventing Financial Elder Abuse

LAW OFFICE OF GEORGE F. DICKERMAN
3879 Brockton Avenue
Riverside, California USA 92501
Tele: (951) 788-2156 (951) 788-2156
Fax: (951) 788-0906

Elder Law Newsletter

Recognizing the signs of financial elder abuse is relatively easy. What's required, is someone who cares enough to get involved. Many well-intentioned friends and neighbors may shy away from any involvement, for fear that they may become accused of intermeddling in family affairs. However, there are many agencies that can be contacted, anonymously, and will investigate allegations of abuse.

Adult Protective Services can provide such assistance. If they find compelling evidence of financial abuse, then they may contact the District Attorney's Office and request further investigation. If the elder appears incapacitated, then a referral from APS can be made to the Public Guardian's Office to determine whether a conservatorship is warranted.

These are just some of the tell tale signs of financial abuse to look for:

• A review of bank statements and checks that show unusual activity such as sudden withdrawals of large sums.
• Numerous ATM withdrawals, particularly when the elder has never used such a debit card.
• Numerous checks written to "cash".
• Signatures on checks that don't match the elder's signature.
  

Suspicious activity could also include a newly created will, trust, or financial power of attorney. Life insurance paperwork or bank documents that indicate a change of beneficiaries are also indicators of wrongdoing.

A key element of such abuse is "isolation". When a caregiver or family member consistently refuses to allow visitation, then a red
flag warning should go up. If abuse is occurring, the last thing a perpetrator wants is to allow someone to have access and possibly discover the abuse.

Prevention occurs when concerned family members, friends and other loved ones get involved with the elder's life and provide assistance. No one wants another to pry into personal financial affairs; however, with good intentions and focusing solely on the best interests of the elder, most will accept such help when needed. Most counties have Area on Aging offices that offer free assistance and can provide other services or resources to prevent future problems from occurring.

When abuse has already occurred, then quick action must be taken to stop the financial bleeding. Immediately contact the relevant financial institutions, law enforcement, Adult Protective Services, and/or an attorney. Many states have "mandated reporter" laws that require, for example, bank employees, medical personnel, and a variety of other persons to report to law enforcement any reasonable suspicion that abuse is taking place.

Recognizing the signs of elder financial abuse makes it easier to take precautionary steps to prevent it from occurring in the first place. As the saying goes, the best offense is a good defense.