Archive for June, 2010

Medicare and Medicaid Under Financial Pressure

Add comment June 30th, 2010

Heavy financial pressures on the federal and state governments are being felt in the Medicare and Medicaid programs.  Both of these programs are important safety nets for the millions of seniors and disabled persons in our country.  However, as the costs of medical and long-term care continue to escalate, the financial impact of these programs on federal and state budgets is dramatic.

The federal government is increasing pressure on private insurers that sell Medicare Advantage plans by freezing payment rates to these insurers in 2011 and reducing them starting in 2012.  Meanwhile, medical costs are increasing by at least 6% per year, and these private insurers are being warned not to increase premiums or co-pays to seniors.  Inevitably, something has to give, and it’s likely to be a reduction in the scope and quality of services.

On the Medicaid front, many states are facing larger-than-expected budget deficits because assumed federal assistance for Medicaid is apparently not going to be awarded by Congress.  New York may be forced to do without $1.1 billion in federal funds that had been penciled into the state budget.

Due to federal mandates regarding health care, the funding shortfalls will result in a reduction of other services, including education, the arts, and even police and fire. Layoffs of government workers are expected.  Medicaid is likely to feel the pinch, as well.

As Elder Law attorneys, we are starting to see a change in attitude at some of the Medicaid offices in local counties, even though the governing laws and rules have not changed.  Rather than being compassionate and helpful, many Medicaid workers, compelled by budgetary pressures, are looking for ways to delay or deny applications for medical assistance or to reduce the scope of services.  Medicaid is also becoming more aggressive about enforcing spousal obligations of support, pursuing liens against real property, and seeking recovery from the estates of Medicaid recipients.

In these times, we believe that it is all the more important for seniors, the disabled, and their families to be aware of their rights to government benefits for medical and long-term care, which can be ruinous if paid from your own funds.  For many, a consultation with an Elder Law attorney will be the best couple of hours you’ve spent in a long time.

Do You Have a Health Care Proxy?

Add comment June 3rd, 2010

A Health Care Proxy is a legal document that allows you (the principal) to appoint another person (the agent) to make health care decisions on your behalf.  A Health Care Proxy only takes effect when you are unable to make health care decisions yourself, usually due to illness or incapacity.  You can only name one person at a time to act as your agent on your Health Care Proxy.  However, alternate agents can be named if your original agent is unable to act at the time a decision needs to be made.

When executing a Health Care Proxy, it is important to appoint an agent who will advocate on your behalf and carry out your health-care wishes.  Make sure this person will be able to make the decisions that you would have made had you been able to, and not substitute his or her own judgment.

It is important to discuss your preferences regarding your health-care and medical treatment with your agent.  Most importantly, be sure to discuss your desires regarding life-sustaining treatment, including artificial nutrition and hydration.  Your Health Care Proxy must specify that your agent knows your wishes in order to make such decisions on your behalf.

Executing a Health Care Proxy offers you control over a situation in which you would otherwise be powerless.  Discussing your wishes regarding end-of-life care with your agent will give your agent direction during a difficult time and the confidence of knowing that your wishes will be carried out.  Do not delay in executing this important document and discussing your wishes with your agent.


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