Elder Law Commons^™

Silver Tsunami Or Silver Rush? Extracting Value From Elders, Andrew Milne

Suffolk University Law School Faculty Works

I examine how the United States finances elder care, arguing that the legal processes structuring elder care tend to widen economic inequality and divide the interests of lower-income people against each other along generational, gendered, and racialized lines. I begin with two case narratives drawn from my practice experience as a poverty lawyer for older adults. One narrative involves an elder homeowner, while the other involves an elder renter. Both face crises of unmet care needs, the threat of homelessness, and ultimately the outcome that many older people dread most: institutionalization in a nursing home. I use these narratives as …

Providing End-Of-Life Counseling: A Narrative Inquiry, Carol Hecht, Sibyl West

Adultspan Journal

This qualitative study aimed to address the gap in the research related to end-of-life counseling by exploring the experiences of counselors working with clients at end of life. While counseling literature and education are lacking regarding end of life, many counselors will work alongside clients approaching death. The purpose of this study was twofold: (a) to better understand the nuanced experiences of counselors providing end-of-life counseling and (b) to explore the supports and preparations helpful for counselors to provide end-of-life counseling. A narrative approach, using the Listening Guide (Gilligan, 2015), was employed to analyze and present the stories of three …

Considerations Of Medicare Telehealth Services With Older Adults, Sonah Kho, Amanda Dediego

Adultspan Journal

The onset of the COVID-19 pandemic set in motion a rapid expansion of mental health services offered via telehealth. With this rapid expansion came the need to examine how policy and practice should be shaped in a future where telehealth is considered common in counseling practice. For counselors to understand how to support older adult clients in using telehealth services, they must understand telehealth policy. Following the eligibility of licensed counselors to participate in Medicare, counselors need to stay abreast of regulatory changes regarding restrictions and regulations on use of telehealth for mental and behavioral health services, including video and …

The Health Care Costs Of Financial Exploitation In Maine, Kimberly I. Snow Mhsa, Yvonne Jonk Phd, Deborah Thayer Mba, Catherine Mcguire Bs, Stuart Bratesman Mpp, Charles A. Smith Phd, Erika C. Ziller Phd

Disability & Aging

This study sought to determine the Medicare and Medicaid costs experienced by dual eligible older adults in Maine for whom Maine Adult Protective Services (APS) substantiated allegations of elder financial exploitation and to compare them to those of Maine’s general older population. The analysis is an important step forward in estimating the medical costs associated with elder abuse.

Elder financial exploitation may result in significant public burden on Medicare and Medicaid, shouldered by taxpayers. Efforts to detect, investigate, prosecute, and mitigate this abuse will benefit not only the victims, but also the financial stewardship of these public programs.

Healthism, Intersectionality, And Health Insurance: The Compounded Problems Of Healthist Discrimination

Marquette Benefits and Social Welfare Law Review

Healthism can identify situations where a person is subject to a particular form of bigotry based on their individual health status. In health insurance, some forms of healthism are unavoidable due to the very nature of health insurance structures. However, when analyzing health insurance programs, particularly those that are funded through government, it is possible to utilize a healthism framework to, first, recognize and minimize and potentially ameliorate the worst effects of healthism combined with intersectionality. This Essay analyzes these issues as they relate to health insurance, Medicare, and the potential role of the Independent Payment Advisory Board.

Wage Theft As Public Larceny, Elizabeth J. Kennedy

Brooklyn Law Review

Home care for the elderly and disabled is a rapidly expanding industry in which structural and regulatory factors contribute to worker vulnerability and exploitation. Systemic exclusion from core federal employment and labor laws, as well as many state and local regulations, results in minimal consequences for employers who violate standards. Despite recent movement at the federal level to create a “new mindset” of rights and regulations, home care workers must be equipped with creative ways to enforce these new rights and to challenge existing gaps in enforcement. With the understanding that two-thirds of the home care industry is financed by …

The Medicaid Gamble, Ann Marie Marciarille

Faculty Works

The Patient Protection and Affordable Care Act (ACA) was an unprecedented gamble. The ACA transformed Medicaid from an unevenly and underfunded program for the poor and disabled to a program to offer those priced out of commercial insurance markets government-funded health insurance similar to Medicare, the single-payer system for seniors and the disabled. In a sense, the ACA gambled that Medicaid could be more like Medicare.

The ACA, as it was transformed by the Supreme Court of the United States, became a gamble on the part of the Court that good things would follow from empowering each of the states …

Observing Observational Status -- Auditors And Inequities

Marquette Elder's Advisor

No abstract provided.

Filial Support Laws In The Modern Era: Domestic And International Comparison Of Enforcement Practices For Laws Requiring Adult Children To Support Indigent Parents, Katherine C. Pearson

Faculty Scholarship

Family responsibility and support laws have a long but mixed history. When first enacted, policy makers used such laws to declare an official policy that family members should support each other, rather than draw upon public resources. This article tracks modern developments with filial support laws that purport to obligate adult children to financially assist their parents, if indigent or needy. The author diagrams filial support laws that have survived in the 21st Century and compares core components in the United States (including Puerto Rico) and post-Soviet Union Ukraine. While the laws are often similar in wording and declared intent, …

The Responsible Patient: The Senior's Obligation To Conserve Medical Resources, Jeffrey B. Hammond

Marquette Elder's Advisor

No abstract provided.

Variables Of Health Reform And Their Impacts On The Elderly, John D. Blum

Marquette Elder's Advisor

No abstract provided.

The Economics Of Prevention And Medicare: The Challenge, Potential Solutions And Current Results, Adam Atherly Ph.D., Zhou Yang

Marquette Elder's Advisor

No abstract provided.

The Future Of Medicare: Preserving A Structurally Sound Program For Tomorrow, Alfred J. Chiplin Jr., Brian W. Lindberg

Marquette Elder's Advisor

This column is an annotated form of a position paper suggesting ways that the Medicare program may be successfully continued into the twenty-first century. Issues discussed are the basic principles to be observed, current concerns and cautions, and concepts for be explored which need further study.

First Bipartisan Medicare Reform Bill, John Breaux

Marquette Elder's Advisor

The proposed Breaux-Frist plan will establish a Competitive Premium System that offers integrated health care benefits and prescription drug coverage while maintaining Medicare entitlement. This article provides an overview of the proposed legislation.

Nursing Facility Coverage Under Medicare, Edward Dale, Cheryldiane Feuerman

Marquette Elder's Advisor

Many beneficiaries believe that Medicare provides substantial coverage for nursing home care. The coverage actually available is of short duration, incomplete, and riddled with limitations. This article discusses the various requirements to receive Medicare benefits for skilled nursing facility admissions, and it also discusses the appeals process for denied benefit claims.

Hospital Coverage Under Medicare, Edward Dale, Cheryldiane Feuerman, Tina Georgiades

Marquette Elder's Advisor

While Medicare appears to afford generous coverage for hospital care, statutory limitations and changes in medical practice often make access to coverage problematic. The difficulties that Medicare beneficiaries face when receiving coverage for inpatient hospital care are discussed in this article.

Protecting The Disabled Individual Through The Use Of A Medicare Set-Aside Trust, Susan G. Haines, John J. Campbell

Marquette Elder's Advisor

In America, plaintiffs in tort settlements receive more benefits, including Medicare benefits, than plaintiffs in worker's compensation cases. A properly established Medicare set-aside trust can guarantee that a disabled worker's Medicare benefits will be available after a worker's compensation settlement. This article discusses the theory behind a Medicare set-aside trust and tips for properly using it.

Paying For Terminal Illness

Marquette Elder's Advisor

The need for public assistance for terminal care has moved death itself from a private family matter to the public professional sphere. Congress intended Medicare hospice coverage to be comprehensive, but its eligibility rules and per diem limits deprive some patients of needed care. This article examines these limits and the alternative models for care of the dying.

An Introduction To Medicare, Cheryldiane Feuerman, Edward Dale

Marquette Elder's Advisor

This column details the nuts and bolds of Medicare, noting that it Medicare is not always as familiar as it should be to beneficiaries, their advisors, or their doctors. This column presents an overview of Medicare's eligibility requirements, coverage, and appeals process.

Finding Internet Sites On Elder Issues: Health And Human Services, Robin C. Schard

Marquette Elder's Advisor

Have you ever heard the term information over load? Do you feel it every time you try to find an exact piece of information on the Internet? Here's the place to start.

The Medicare Managed Care Choice

Marquette Elder's Advisor

Medicare managed care still has problems and careful evaluation is critical when choosing a program. Government attempts at providing information have created further confusion and drawn criticism from the professionals. This overview highlights some of the most important issues.

Internet Resources Related To Nursing Care Facilities, Robin C. Schard

Marquette Elder's Advisor

Schard uses this column to list a number of internet sources available to assist in evaluating various nursing care facilities, and gives a brief overview of what these sites provide. A few of the numerous sites described are the Joint Commission on Accreditation of Healthcare Organizations, the American Health Care Association, and the AARP.

Home-Health Care Coverage Under Medicare, Edward M. Dale, Cheryl Diane Feuerman

Marquette Elder's Advisor

This column describes the criteria prerequisites for Medicare coverage of home care, including definitions of homebound status, the requirements for physician certification, and the availability of Medicare managed care programs. As the national cost of home care increased, regulations to rein in costs were enacted. The effects of these changes are discussed in detail.

Internet Resources For Long-Term Care Insurance, Robin C. Schard

Marquette Elder's Advisor

This article looks at long-term care insurance on the Web. The various perspectives represented and information provided by insurance governance, organizations, consumer advocacy groups, and insurance companies create a solid basis for beginning the decision making process with regard to LTC insurance.

Medicare Handbook, Jane M.R. Mulcahy

Marquette Elder's Advisor

No abstract provided.

Remarks Of Senator Charles Grassley To The Aarp's Board Of Directors, Charles Grassley

Marquette Elder's Advisor

On February 14, 2001, Senator Grassley addressed the board of directors of the AARP. His remarks concerned matters of interest to all elderly Americans.

Medicare Reasonable And Medically Necessary Care: Skirmishes At The Front

Marquette Elder's Advisor

Medicare covers costs for health care deemed "reasonable and necessary" and excludes care classified as "experimental, investigative, or unproven." This article discusses coverage limits and the exceptions for which Medicare will authorize payment.

Introduction To Medicare For People With Multiple Sclerosis, Judith Stein

Marquette Elder's Advisor

Stein explains what criteria are necessary for Medicare parts A, B, C, and D coverage, and why eligible recipients with Multiple Sclerosis are often erroneously denied coverage. Recent changes in applicable Medicare regulations are explored, as are some of the differences between Medicare and Medicaid. Various ways attorneys can help their clients through the application maze are discussed.

Essay: The Re-Tooling And Re-Telling Of The Social Security, Medicare, And Medicaid Programs: Will We Retain The Sixty-Year-Old Values Of A "National Community" Or Begin With A "Clean Slate?", Stephanie Sue Stein

Marquette Elder's Advisor

This essay focuses on the change taking place in America's attitude towards major social programs that benefit the elderly. Stein suggests that reforming these programs reverses the concept of the national community providing for the needs of the elderly to letting people decide how best to provide for themselves in retirement, to the detriment of many of our most needy and vulnerable elderly.

Medicare Advantage Private Fee-For-Service Plans: What Privatization Means For Today's Beneficiaries, Melissa M. Ostrowski

Marquette Elder's Advisor

Originally solely a government-administered program, Medicare is now offering options involving private insurers. Private fee-for-service plans may offer additional benefits and lower out-of-pocket costs. These plans are expected to have lower administrative costs, but currently require a government subsidy. Advantages and disadvantages of such plans are discussed, and examples showing detailed cost comparisons of two plans, SmartValue Classic and Humana Gold Choice, are given.