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⭒ News & Notes Archive

November 2019

In this Issue

2020 Medicare Parts A & B Premiums and Deductibles 

On November 8, 2019, the Centers for Medicare & Medicaid Services (CMS) released the 2020 Medicare Parts A and B premiums, deductibles, and coinsurance amounts.  Consumers will pay more in 2020 than in 2019, including an increase in the coinsurance under Medicare Part A for days 21-100 of a skilled nursing facility stay to $176 per day ($170.50 in 2019).
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Replacement Medication, Medical Supplies and Medical Equipment for Medi-Cal Recipients Impacted by Wildfires and Power Shutoffs

On October 31, 2019, in response to the Governor’s proclamation of a statewide emergency due to the risk of wildfires, the Department of Health Care Services (DHCS) issued updated guidance for dispensing replacement medication(s) to impacted recipients.  On November 7, 2019, DHCS provided additional guidance for dispensing medical supplies and durable medical equipment.  Read More

Health Journal Article Says Nursing Homes Violate Human Rights

new article in the International Journal of Health Services analyzes the state of nursing home care in the U.S. and finds systemic violations of domestic laws and regulations and international human rights standards. After reviewing various recent studies and nursing home data, the authors cite abuse, sexual assaults, chemical restraints, persistent understaffing, and various forms of neglect to conclude residents are not protected as required under international standards. In fact, some severe forms of abuse or neglect “could be considered torture.” The authors call for increasing enforcement of domestic rules and zero tolerance for facilities and facility owners that cause repeated abuse or neglect to address the urgent human rights crisis in America’s nursing homes.

OIG Reports California Nursing Homes are Poorly Prepared for Emergencies

An alarming new report – California Should Improve Its Oversight of Selected Nursing Homes’ Compliance With Federal Requirements for Life Safety and Emergency Preparedness – by the federal HHS Office of Inspector General (OIG) states California nursing home residents are at increased risk of injury or death during a fire or other emergency due to widespread violations of critical safety standards. In examining emergency preparedness at 20 unnamed California nursing homes from September to December 2018, OIG found serious violations at every nursing home, including 188 violations of emergency preparedness requirements and 137 violations of life safety requirements. One of the nursing homes OIG inspected was later destroyed by a wildfire, illustrating the grave risks facing California nursing home residents today.

The report states the violations were caused by poor management and high staff turnover.  OIG also pointed the finger at the California Department of Public Health (CDPH) for poor enforcement of emergency preparedness standards. It recommended CDPH conduct more follow-up visits at non-compliant nursing homes to ensure they are prepared for emergencies. CDPH, which often seems to tolerate dangerous conditions in nursing homes, rejected the recommendation.
Read California Healthline’s November 14, 2019 article on the OIG report.

Ways & Means Committee Holds Hearing on Care Needs of Aging Americans

On November 14, 2019, the Ways & Means Committee of the U.S. House of Representatives held a hearing – Caring for Aging Americans – that addressed major problems with America’s long-term care system and systemic changes that are needed to fix them. Several witnesses presented testimony on issues including the plight of caregivers, poor enforcement of nursing home standards, elder justice concerns, dementia and hospice care, the need to improve our eldercare system, and more. Their statements are available on the Ways & Means website
Click here to watch the hearing. 

New Issue Brief on Adding Dental Benefit to Medicare to Address Racial Disparities

Justice in Aging has issued a new issue brief, Adding a Dental Benefit to Medicare: Addressing Racial Disparities.  The brief examines how adding an oral health benefit to Medicare would address racial disparities in access to care and oral health outcomes, and sets forth additional policy options that could further advance oral health equity.  The brief concludes as follows:

Lack of oral health coverage is the biggest barrier to accessing oral health treatment for the 60 million Medicare beneficiaries who rely on the program, particularly populations of color. Multiple bills have been introduced in Congress this year that would add a dental benefit to Medicare, and, if passed, would help to address coverage and access disparities in oral health treatment based on race. At the same time, advocates, health providers, dental schools, policymakers, and other stakeholders have the opportunity to address disparities in oral health care through changes in policies, practices, and systems.
Read the brief

2020 Medi-Cal Spousal Impoverishment MMMNA & CSRA Rates

Spousal impoverishment protections are Medi-Cal rules designed to prevent the impoverishment of one spouse, when the other spouse enrolls in Medi-Cal payment for nursing home care, or “Home and Community Based Services,” by providing for more generous income and asset limits.  The income limit is called the Minimum Monthly Maintenance Needs Allowance (MMMNA), and the asset limit is called the Community Spouse Resource Allowance (CSRA).  The California Department of Health Care Services adjusts the MMMNA and CSRA annually for cost of living increases.  Effective January 1, 2020, the MMMNA will be increased to $3,217 monthly, and the CSRA will be increased to $128,640.

Major Reform Legislation Introduced to Improve Nursing Home Care

On November 21, 2019, Congresswoman Jan Schakowsky (D-IL) and Senator Richard Blumenthal (D-CT) introduced H.R. 5216 and S.2943, the Quality Care for Nursing Home Residents Act of 2019. If enacted, the bill would make major improvements to federal nursing home standards by setting minimum nurse staffing levels, banning forced arbitration agreements, requiring written informed consent for use of psychotropic drugs, and more. CANHR and other leading advocacy organizations for nursing home residents have endorsed the bill.

Nursing Home Residents Can Go Home for the Holidays

As the holidays approach, nursing facility residents and their family members often worry about losing their rooms, or their Medicare status, if they leave a nursing facility for brief periods of time. In its annual holiday alert, the Center for Medicare Advocacy reports that nursing home residents may leave their facility for family events without losing their Medicare coverage.  
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CANHR on the Move

Keynote Speaker Betsy Butler, Bill Taylor Memorial Award Recipient Kathryn Stebner, CANHR Executive Director Pat McGinnis, and Tim Millar Estate Planning Award Recipient Carlos Arcos
Legal Services Warriors at CANHR Elder Law Conference in Monterey