Tag: Sen. Susan Collins

Website Errors Raise Calls For Medicare To Be Flexible With Seniors’ Enrollment

Seniors will be able to change plans any time next year if they discover their coverage doesn’t provide what the government’s Plan Finder promised. 

By Susan Jaffe  | Kaiser Health News | December 6, 2019 | This article also ran on

Saturday is the deadline for most people with Medicare coverage to sign up for private drug and medical plans for next year. But members of Congress, health care advocates and insurance agents worry that enrollment decisions based on bad information from the government’s revamped, error-prone Plan Finder website will bring unwelcome surprises.

Beneficiaries could be stuck in plans that cost too much and don’t meet their medical needs — with no way out until 2021.

On Wednesday, the Centers for Medicare & Medicaid Services told Kaiser Health News that beneficiaries would be able to change plans next year because of Plan Finder misinformation, although officials provided few details. [Continued at Kaiser Health News or NPR.]   …

Home Health Care Providers Struggle With State Laws And Medicare Rules As Demand Rises

“We can send prescriptions to the pharmacy, including [for] narcotics,” says Marie Grosh, a geriatric advanced practice nurse practitioner and the owner of a medical house calls practice in a Cleveland suburb. “We can order lab work, x-rays, ultrasounds, EKGs [electrocardiagrams]; interpret them; and treat patients based on that. But we’re just not allowed to order home care—which is absurd.”

By SUSAN JAFFE  | Health Affairs | June 2019 | Volume 38, Number 8

When Christine Williams began working as a nurse practitioner some forty years ago in Detroit, Michigan, older adults who couldn’t manage on their own and had no family nearby and no doctor willing to make house calls had few options besides  winding up in a nursing home.

Not anymore.

Home check: Nurse practitioner Marie Grosh visits Leroy Zacharias at his home in a Cleveland suburb, He has Parkinson disease, and Grosh says he would be living in a nursing home if he couldn’t get medical care at home. (Photo by Lynn Ischay.)

“The move towards keeping seniors in their homes is a fast-galloping horse here,” says Williams, who settled in Cleveland, Ohio, more than a decade ago. “We don’t have space for them in long-term care [facilities], they don’t want to be in long-term care, and states don’t want to pay for long-term care. And everybody wants to live at home.”

But despite the growing desire for in-home medical care for older adults from nearly all quarters, seniors’ advocates and home health professionals claim that rules set by the Centers for Medicare and Medicaid Services (CMS)  along with  state regulations have created an obstacle course for the very providers best positioned—and sometimes the only option—to offer that care.  [Continued here] …

Counting On Medicaid To Avoid Life In A Nursing Home? That’s Now Up To Congress.

By Susan Jaffe | KAISER  HEALTH  NEWS | July 31, 2017 |This story also ran in 

Ten years ago, a driver ran a stop sign as Jim McIlroy rode into the intersection on his motorcycle. Serious injuries left McIlroy paralyzed from the chest down. But, after spending some time in a nursing home, he returned to his home near Bethel, Maine.

McIlroy does most of his own cooking since Maine’s Medicaid program paid for a stovetop that he can roll his wheelchair underneath to reach the food-prep area. His

Esther Ellis received a new mattress earlier this year from Partners in Care, a nonprofit that runs four of the dozens of sites in California’s Multipurpose Senior Services Program, a Medicaid-funded home services program. (Heidi de Marco/KHN)

new kitchen sink has the same feature. Wheelchair-friendly wood flooring has replaced McIlroy’s wall-to-wall carpeting.

The alterations plus a personal care aide — all paid for by Medicaid — enable McIlroy to stay in his house that he and his wife, who has since died, “worked really hard to own,” he said. The arrangement also saves Medicaid roughly two-thirds of what it would cost if he lived in a nursing home.

McIlroy depends on the federal-state program’s growing support of home-based care services — along with 2 million elderly or disabled Americans who rely on them to live at home for as long as possible.

However, that crucial help could face severe cuts if congressional Republicans eventually succeed in their push to sharply reduce federal Medicaid funds to states. [Continued at Kaiser Health News and USA Today] 

 

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