Medicare Observation Status: Denying Medicare Coverage for Skilled Nursing Home Care

The Voice® Newsletter

May 2015 – Vol. 9, Issue 6

There is an increasing trend to admit Medicare beneficiaries for “observation” as outpatients rather than admitting them as regular hospital patients. This practice may prevent patients from obtaining proper inpatient and post-hospital care under Medicare. Since many individuals with disabilities depend on Medicare as their primary health insurance coverage, this practice can have a serious impact on individuals with disabilities who may need rehabilitation or other post-hospital care.

A Medicare beneficiary who is admitted on an inpatient basis to a hospital for at least three nights is normally entitled to limited Medicare benefits post discharge for skilled care in a rehabilitation center or nursing home. Part A can cover nursing home rehab or skilled care 100% of the first 20 days and all but $157.50 per day for up to an additional 80 days of treatment, but this benefit is only available after an “inpatient” hospital stay for the required three nights.

Unknown to many Medicare beneficiaries, Medicare for many years has differentiated between Medicare beneficiaries admitted as inpatients whose hospital stays are covered by Medicare Part A and Medicare beneficiaries admitted as outpatients for observation (outpatient care) to determine whether it is necessary to admit the beneficiary as an “inpatient”.

The Center for Medicare and Medicaid Services’ (CMS) definition of “observation status” under Part B is considered to be “outpatient” care, and is intended for assessment and treatment that can generally be performed in a 24 to 48 hour period.

Medicare beneficiary “outpatients” are covered by Part B which covers 80% (after the Part B deductible of $147 per year) of outpatient services billed at the Medicare rate. Outpatients, even with a three night hospital stay, do not qualify for the broad 20 day full and 80 day partial Medicare coverage of post-hospital skilled care that is available under Part A after the minimum required hospital stay.

Medicare beneficiary hospital “outpatients” do not qualify for Medicare payments for post-hospital nursing home skilled care no matter how long the hospital stay or how acute and medically necessary the services provided to them.

What is Causing this Problem?

The Office of Inspector General (OIG) issued a memorandum reporting that in 2012 over 600,000 Medicare beneficiaries had hospital stays of three or more nights, but did not qualify for Part A coverage, because they were not “inpatients” for three nights. The OIG report recommends that CMS consider how to ensure that beneficiaries with similar post-hospital care needs have the same access to and cost-sharing for SNF (skilled nursing facility) services. The report states that while some hospitals classify only 5% of patients as “outpatients” others classify up to 90% as “outpatients.” This disparity reflects a significant change on the part of some hospitals that in turn has resulted in an alarming loss of Medicare coverage for Medicare beneficiaries receiving post-hospital treatment.

What is causing this increased use of observation-outpatient classification by hospitals? It appears that the auditing procedure established by Medicare in 2010 to detect and prevent Medicare fraud is the driving force behind the upswing in outpatient classifications. These audits are conducted by private contractors who are paid based upon the Medicare reimbursements to hospitals that the contractors identified as being unnecessary and required the hospitals to pay back to Medicare.

According to the American Hospital Association (AHA) there are several problems with these audits. The AHA says the contract auditors have an inherent conflict of interest with making the audits because they are paid based upon the amount of money they recover from their denials of coverage. These audits often determine that necessary medical services should have been delivered on an outpatient basis instead of by admission as a hospital patient. When the hospitals have to repay Medicare for their charges, they may be unable to re-bill Medicare under Part B rather than Part A. The hospitals thus risk losing a significant amount of revenue Medicare had paid them if they bill Medicare under Part A. Rather than risk having an inpatient bill to Medicare denied, the hospitals resort to billing Medicare for outpatient care under Part B. The subsequent loss to the patient of nursing home or rehab coverage under Part A is an unintended by-product of this practice.

The hospitals and affected Medicare beneficiaries have filed several lawsuits to get the audit process modified, and in 2013 the rules were modified to direct a physician to admit a patient as an inpatient if the physician believes the patient will require at least a two night stay. While it is sometimes helpful, this new rule does not remove the three night inpatient hospital requirement in order to have coverage for post-hospital rehabilitation or skilled care. The risk to the hospitals that Medicare may after the fact deny Part A coverage for three day hospital stays continues to affect hospital practices. This problem continues to cause hardship to patients for post-hospital care because hospitalization continues to be a requirement for nursing home and rehabilitation coverage under Part A.

The Solution to the Problem

There is a bill pending in Congress, the Improving Access to Medicare Coverage Act of 2013, (H.R. 1179) introduced by Joe Courtney (D-CT) and Tom Latham (R-IA), that would classify outpatient/observation services as inpatient services for purposes of meeting the three night hospital stay requirement for Part A coverage of hospital and post-hospital skilled care. This bill is a bi-partisan effort, supported by 106 Representatives and 24 Senators and many national organizations. It did not pass during the 2014 Session of Congress, however sponsors have reintroduced this bill in the 2015 Congressional Session. Individuals with disabilities, their family members and advocates should encourage their legislators to support this legislation.


About this Newsletter: We hope you find this newsletter useful and informative, but it is not the same as legal counsel. A free newsletter is ultimately worth everything it costs you; you rely on it at your own risk. Good legal advice includes a review of all of the facts of your situation, including many that may at first blush seem to you not to matter. The plan it generates is sensitive to your goals and wishes while taking into account a whole panoply of laws, rules and practices, many not published. That is what The Special Needs Alliance is all about. Contact information for a member in your state may be obtained by calling toll-free (877) 572-8472, or by visitingthe Special Needs Alliance online.


Requirements for Reprinting this Article: The above article may be reprinted only if it appears unmodified, including both the author description above the title and the “About this Newsletter” paragraph immediately following the article, accompanied by the following statement: “Reprinted with permission of the Special Needs Alliance – www.specialneedsalliance.org.”

The ABLE Act – A New Tool for Special Needs Planning

The Voice® Newsletter

April 2015 – Vol. 9, Issue 4

This installment of the Voice was written by Robert B. Fleming. Robert is a partner in Fleming & Curti, PLC, a Tucson law firm focusing on special needs planning, trust administration, guardianship/conservatorship and estate planning. He is a Fellow of the American College of Trust and Estate Counsel, and also of the National Academy of Elder Law Attorneys. He has been a member of the Special Needs Alliance since its founding, and was one of the original co-authors of the SNA’s Handbook for Trustees, the free online guide to managing special needs trusts.

The ABLE Act – A New Tool for Special Needs Planning

If you want to set aside money for the education of a child (or a grandchild, or anyone else), you can choose from a variety of options. One popular choice is to establish a “529 Plan” fund. These education accounts are named after the tax code section authorizing their use, and they make it easy and inexpensive to create education accounts.

Advocates have long championed a similar concept for people with disabilities. Years of legislative work finally resulted in approval of the Achieving a Better Life Experience (ABLE) Act last December. The new law allows states to set up programs that permit people with disabilities – or their family members – to make contributions to similar accounts.

Rather than focusing on educational needs, the new ABLE Act accounts are to help pay for disability-related expenses – and there are a few other differences between ABLE Act and 529 Plan accounts. The new law creates interesting planning possibilities.

Though many people with disabilities will benefit from the ABLE Act, not everyone will. There are a number of limitations on the use of the new accounts, including:

  • Only individuals whose disability was established before age 26 can set up ABLE Act accounts. This may seem unfair to people who acquired their disabilities later in life (or who might have been disabled but undiagnosed at earlier ages), but the age requirement was designed to limit the number of people who could qualify.
  • Only individuals living in a state that has authorized ABLE Act accounts can participate. If a given state declines to authorize ABLE Act accounts at all, its residents cannot create ABLE Act accounts.
  • Only one ABLE Act account can be established per individual but there is no limitation on the number of individuals who can contribute to that one account.
  • Total contributions for the benefit of a given ABLE Act beneficiary cannot exceed $14,000 in a single year. That figure is expected to increase by $1,000 every few years, but will always be keyed to the maximum federal gift tax exclusion amount.
  • Upon the death of an ABLE Act participant, every dollar remaining in the account – including gifts from family members, and earnings in the account itself – must be paid to the state Medicaid agency to repay costs of care received by the participant during life. If the account should grow large enough to fully repay that Medicaid cost, any remaining funds can go to family members or other beneficiaries.
  • If the ABLE Act account exceeds $100,000, the participant will lose eligibility for Supplemental Security Income (SSI) – but not for Medicaid. The account can grow to a much higher number (between $235,000 and $452,210, depending on the state) before Medicaid eligibility is lost.
  • While ABLE Act funds can be used to pay for “qualified disability expenses” (a term that is not yet fully defined), any payments for other purposes may mean the account is instantly countable as a resource, disqualifying the participant from SSI and Medicaid eligibility.

Those are the most important limitations, but they will not be a problem for many ABLE Act participants. Individuals with disabilities (and their family members) might well wonder whether the ABLE Act offers a useful alternative for them. Who will most likely benefit from ABLE Act accounts?

The beneficiary who saves money. Supplemental Security Income payments are limited to $733/month (in 2015). Some people who qualify for SSI receive a state supplement to that figure, and a few might qualify for additional benefits that increase that figure slightly. It can be very hard to save money on an income that is so limited.

Some individuals with disabilities do manage to save money, though. For the beneficiary who is regularly trying to figure out how to spend down below the $2,000 asset limitation level, the ABLE Act might have opened up a very attractive opportunity. Is your personal account getting close to $2,000? You might be able to move, say, $1,000 into your ABLE Act account, and not have to buy a new computer, or furniture, or a prepaid burial account. Depending on your finances and the final government regulations, you might actually be able to save money for the later purchase of a vehicle, or possibly even a home.

The beneficiary with a small inheritance or personal injury lawsuit. If you are an SSI or Medicaid recipient, and your grandmother leaves you $10,000 in her will, you will lose your SSI (and might, depending on your state, lose Medicaid eligibility as well). Same if you are slightly injured in a car collision and your net settlement is $12,000.

The ABLE Act opens up a new possibility. You might be able to move your small inheritance or personal injury settlement into a new ABLE Act account, and continue your benefits uninterrupted. That way you can figure out how to spend the money over the next few months or years, rather than having to get it spent down within the next two or three weeks.

Note, though, that this only works for amounts under the $14,000 annual exclusion amount – at least in most cases. If the money arrives in, say, December, it might be possible to spread contributions across two calendar years. There might be other opportunities to spread payments out to fully utilize the ABLE Act. It will be very difficult, however, to handle a $50,000 inheritance or a $100,000 personal injury settlement this way.

The parent (or grandparent) with a small estate and a fear of lawyers. Do you intend to leave money to your child (or grandchild, or family friend) with a disability? You almost certainly should be setting up a special needs trust. But if you really are only going to leave, say, $10,000 to your child, then you could consider making the gift to an ABLE Act account. You will subject your money to the payback requirement upon your child’s death, but maybe that is not a very large concern for you.

The family very interested in giving their child more autonomy and control. Maybe you are less worried about the amount of money and the possibility of having to pay back the state Medicaid agency, and more concerned about the personal dignity and autonomy flowing from your child having control over at least small amounts of money. You can’t put $5,000 into their checking account because it would make them ineligible for SSI (and maybe for Medicaid). But you could put that same $5,000 into an ABLE Act account and your child could have almost full control over the use of the funds. The value of that self-determination might well be worth more than the limitations in the ABLE Act.

The special needs trustee who wants to give a beneficiary more control. As with family contributions, it might sometimes be a good idea for a special needs trust to put money into an ABLE Act account. It’s not yet completely clear when this might work – but small payments from at least some kinds of special needs trusts might benefit the ABLE Act participant.

There are quite a few unanswered questions. The Internal Revenue Service and the Social Security Administration both need to adopt regulations defining terms and setting final limits. States need to adopt ABLE Act account legislation (though a handful are well on their way to accomplishing that step already). The financial industry needs to actually set up the accounts. Then, and only then, will you be able to open an ABLE Act account.

Will ABLE Act accounts be a huge game-changer for people with disabilities? No – but they are one more tool available to individuals and their families. You should discuss ABLE Act accounts with the lawyer who helped you prepare your special needs trust. Thank Congress for introducing this new option and all of the advocacy organizations who spent years lobbying Congress to pass the ABLE Act. Finally, advocate in your state for the enabling legislation necessary before you can use the ABLE Act.


About this Newsletter: We hope you find this newsletter useful and informative, but it is not the same as legal counsel. A free newsletter is ultimately worth everything it costs you; you rely on it at your own risk. Good legal advice includes a review of all of the facts of your situation, including many that may at first blush seem to you not to matter. The plan it generates is sensitive to your goals and wishes while taking into account a whole panoply of laws, rules and practices, many not published. That is what The Special Needs Alliance is all about. Contact information for a member in your state may be obtained by calling toll-free (877) 572-8472, or by visiting the Special Needs Alliance online.


Requirements for Reprinting this Article: The above article may be reprinted only if it appears unmodified, including both the author description above the title and the “About this Newsletter” paragraph immediately following the article, accompanied by the following statement: “Reprinted with permission of the Special Needs Alliance – www.specialneedsalliance.org.”

Disaster Preparation for Seniors

Disaster Preparedness for Seniors

Submitted by Ashley Stepps, Associate Attorney

Arkansas Department of Emergency Management (ADEM) urges all Arkansans to prepare for severe weather by reviewing Family Emergency Plans and severe weather preparedness information, developing a home disaster supply kit and creating a Family Emergency Communications Plan. Emergencies and disasters can strike quickly and without warning and can force you to evacuate your neighborhood or be confined to your home. What would you do if your basic services: water, gas, electricity or communications, were cut off?

By planning ahead you can avoid waiting in long lines for critical supplies, such as food, water and medicine and you will also have essential items if you need to evacuate. Even if you have physical limitations, you can still protect and prepare yourself. Advance planning and quick response are the keys to surviving a tornado or severe weather

Designate an area in the home as a shelter, and practice having everyone in the family go there in response to a tornado threat. For your safety and comfort, have a disaster supplies kit packed and ready in one place before a disaster hits. Assemble enough supplies to last for at least three days.

Your “Go Bag” should contain items such as: (This could be a link to separate document)

    • Store your supplies in one or more easy-to-carry containers, such as a backpack or duffel bag.
    • You may want to consider storing supplies in a container that has wheels
    • Be sure your bag has an ID tag.
    • Label any equipment, such as wheelchairs, canes or walkers, that you would need with your name, address and phone numbers.
    • Water — one gallon per person, per day (3-day supply for evacuation and 2-week supply for home)
    • Food — it is a good idea to include foods that do not need cooking (canned, dried, etc.) (3-day supply for evacuation and 2-week supply for home)
    • Non-electric can opener
    • Flashlight with extra batteries and bulbs (do not use candles)
    • Battery-operated or hand-crank radio
    • First aid kit and manual
    • Medications (7-day supply) and medical items
    • Multi-purpose tool (several tools that fold up into a pocket-sized unit)
    • Sanitation and personal hygiene items (toilet paper, plastic garbage bags)
    • Laminated copies of personal documents (medication list and pertinent medical information, deed/lease to home, birth certificates, insurance policies)
    • Cell phone with an extra battery and charger(s)
    • Family and friends’ emergency contact information
    • Cash and coins (ATMs may not be accessible)
    • Emergency blanket
    • Map(s) of the local area
    • Whistle (to attract the attention of emergency personnel)
    • One change of clothing and sturdy shoes
    • Pet supplies (including food and vaccination records)
    • Extra set of keys (car, house, etc.)
    • Pack of cards to provide entertainment and pass the time

Keeping your kit up-to-date is also important. Review the contents at least every six months or as your needs change. Check expiration dates and shift your stored supplies into everyday use before they expire. Replace food, water and batteries, and refresh medications and other perishable items with “first in, first out” practices.

DEVELOP AN EMERGENCY COMMUNICATION PLAN

In case family members get separated from one another during a tornado (a real possibility during the day when adults are at work and children are in school), have a plan for getting back together.

  • Carry family contact information in your wallet.
  • Ask an out of state relative or friend to serve as the “family contact”. After a disaster, it’s often easier to call long distance than locally.
  • Make sure everyone in the family knows the name, address and phone number of the contact person.
  • Ask about the emergency plans and procedures that exist in your community.

If you receive home care, speak with your case manager to see what their plan is in times of emergency and how they can assist with your plan.

DURING SEVERE WEATHER OR A TORNADO

  • Go at once to the basement, storm cellar or the lowest level of the building
  • If there is no basement, go to an inner hallway or smaller inner room without windows, such as a bathroom or closet.
  • Get away from windows.
  • Go to the center of the room. Stay away from corners, as they tend to attract debris.
  • Get under a sturdy piece of furniture such as a work bench or heavy table or desk and hold on to it.
  • Use your arms to protect your head and neck.

IF YOU NEED TO EVACUATE

  • Organize with your family and home care provider for evacuation procedures.
  • Try to carpool, if possible.
  • Let your out-of-town contact know when you left and where you are going.
  • Wear appropriate clothing and sturdy shoes.
  • Take your disaster supplies kit – “go bag.”
  • Lock your home.
  • Use the travel routes specified or special assistance provided by local officials. Don’t take any short cuts, they may be unsafe.
  • Take your pets with you if you evacuate.
    • However, be aware that pets (except service animals) are not permitted in emergency public shelters for health reasons.
    • Prepare a list of family, friends, boarding facilities, veterinarians and ‘pet-friendly’ hotels that could shelter your pets in an emergency

PLAN FOR THOSE WITH DISABILITIES

  • Keep support items like wheelchairs and walkers in a designated place so they can be found quickly. This step is essential for those who have home-health caregivers, particularly for those who are bed bound.
  • If you wear hearing aids or assistive devices, consider storing them in a bedside container that is attached to your nightstand using Velcro. Some disasters (e.g., earthquakes) may shift items that are not secured, making them difficult to find quickly.
  • If you live in a senior community become familiar with any disaster notification plans that may already exist. Talk to your community management or resident council about how you can all be more prepared together.

IMMEDIATELY AFTER A DISASTER

  • If the emergency occurs while you are at home, check for damage using a flashlight. DO NOT light matches or candles or turn on electrical switches. Check for fires, chemical spills and gas leaks.
  • Shut off any damaged utilities.
  • Check on your neighbors, especially those who are elderly or have disabilities.
  • Call your out-of-town contacts and let them know you are okay.
  • Stay away from downed power lines.
  • Do not drive through flooded roads.
  • Monitor local broadcasts for information about where you can get disaster relief assistance.
  • Turn off or unplug all major appliances (e.g., stove, refrigerator, dryer). They could be damaged by the electrical surge when the power is restored.
  • Keep refrigerator and freezer doors closed as much as possible.
  • Use portable generators cautiously. Make sure they are operated only out-of-doors in a well-ventilated area. Refuel a generator only after it has cooled. Do not connect a generator to your home’s electrical system except though an approved transfer switch installed in compliance with the local electrical code.

FINANCIAL EXPLOITATION/SCAMS

Unfortunately, after a disaster there may be some people who will try to take advantage of your vulnerability. Beware of high-pressure sales, disclosing personal financial information (account numbers and credit card information) and services provided with no written contract. For information on scams, go to www.ftc.gov.

ARKANSAS DISASTER ASSISTANCE MANUAL

Legal Aid of Arkansas, with the assistance of AmeriCorps attorney, Tiffany Keb, and in collaboration with community partners, has created an Arkansas Disaster Assistance Manual for the State of Arkansas. View the Legal Aid of Arkansas’s Disaster Assistance Manual

Process of Providing Legal Services if a Natural Disaster Occurs in Arkansas

The Young Lawyers Section of the Arkansas Bar Association coordinates disaster legal assistance through the program Disaster Legal Assistance in Arkansas. Disaster Legal Assistance may be initiated if there is a request from ADEM (for State disasters declared by the governor) or Federal Emergency Management Agency (FEMA) (disasters declared by the President).

Additionally, the Program may be initiated in response to non-declared emergencies. For information about how you can volunteer for the disaster relief program, contact the Arkansas Bar Association.

How do I apply for disaster help through the Disaster Legal Assistance program of the Arkansas Bar Association?

Call 800-650-0856, or if you are in Pulaski County, call 501-375-4606.

Summary of Disability Benefits – Special Needs Alliance

Summary of Disability Benefits – Special Needs Alliance.

The Voice® Newsletter
January 2015 – Vol. 9, Issue 1

There are many federal government benefit programs available to individuals with disabilities. Programs are often referred to by confusing acronyms (LIEAP, SNAP, QMB, to name just a few) and some programs are very different but sound similar (for instance, Medicare and Medicaid or SSI and SSDI). The following chart lists the most common federal government benefit programs with a brief description of the program benefits and eligibility requirements.

Summary of Disability Benefits

There are many federal government benefit programs available to individuals with disabilities. Programs are often referred to by confusing acronyms (LIEAP, SNAP, QMB, to name just a few) and some programs are very different but sound similar (for instance, Medicare and Medicaid or SSI and SSDI). The following chart lists the most common federal government benefit programs with a brief description of the program benefits and eligibility requirements.

Keep in mind that this chart is only a summary. There are many Voice articles that discuss many of these programs in depth. There are also some state-by-state variations, so you should not rely on this chart as the only source of information regarding eligibility requirements for programs offered in your state. Some benefits are optional and may not be offered in your state or may be more or less generous than benefits offered in another state.

This chart can also be a helpful guide to attorneys who are settling a case for an individual who may be eligible for or receiving government disability benefits. It is important to know which benefits will be affected by receipt of a lump sum and which benefits will be affected by receipt of monthly income from an annuity payment (often referred to as a structured settlement). A few programs with an asset limit allow the recipient of benefits to shelter a lump sum in a specific type of trust to preserve eligibility.

There are two acronyms in the chart that need a brief explanation. SNT refers to a special needs trust, specifically a first party special needs trust or Medicaid payback trust. Again, there are many Voice articles that provide a detailed explanation of SNTs. The second acronym is FPG which refers to the federal poverty guidelines. Some states use the acronym FPL which stands for federal poverty level. Every year in January the Department of Health and Human Services (HHS) publishes income guidelines (http://aspe.hhs.gov/poverty/14poverty.cfm.) to determine whether a family or individual is considered to be living under the poverty level. Many state and federal benefit programs base eligibility on a specified percentage of the FPG. There are different FPG numbers for Hawaii and Alaska; the chart just shows income limits for the other 48 states and District of Columbia.

This chart is intended to be a checklist or starting point to be sure important benefits are available to individuals with disabilities. Consulting with an attorney knowledgeable in the area of special needs trusts and disability benefits is the best way to ensure that all possible benefits are considered and eligibility for those benefits is protected.

About this Newsletter: We hope you find this newsletter useful and informative, but it is not the same as legal counsel. A free newsletter is ultimately worth everything it costs you; you rely on it at your own risk. Good legal advice includes a review of all of the facts of your situation, including many that may at first blush seem to you not to matter. The plan it generates is sensitive to your goals and wishes while taking into account a whole panoply of laws, rules and practices, many not published. That is what The Special Needs Alliance is all about. Contact information for a member in your state may be obtained by calling toll-free (877) 572-8472, or by visiting the Special Needs Alliance online.

Requirements for Reprinting this Article: The above article may be reprinted only if it appears unmodified, including both the author description above the title and the “About this Newsletter” paragraph immediately following the article, accompanied by the following statement: “Reprinted with permission of the Special Needs Alliance – www.specialneedsalliance.org.”

The Costs of Stinginess in Medicaid

A New York Times article that mentions the Arkansas Medicaid program spending on children.

The Costs of Stinginess in Medicaid – NYTimes.com.

Waiting to eat at a Salvation Army in Texarkana, Ark. Arkansas’s poverty rate is twice Vermont’s, but it spends less on Medicaid. Credit Michael Stravato for The New York Times

Waiting to eat at a Salvation Army in Texarkana, Ark. Arkansas’s poverty rate is twice Vermont’s, but it spends less on Medicaid. Credit Michael Stravato for The New York Times

Two Significant Changes for Individuals with Special Needs

Aid Children with Disabilities of Military Families

Congress passed  provisions on December 12, 2014 that protect children with disabilities of members of the military by allowing their parents’ survivor benefits to go into a special needs trust.

The provisions were passed as part of the National Defense Authorization Act (NDAA) of 2015 and are substantively equivalent to the Disabled Military Child Protection Act sponsored by Sen. Kay Hagan (D-NC) and Rep. Jim Moran (D-VA).

Until these provisions are signed into law, the military parents’ survivor benefits of children with disabilities must go directly to the children, which means they could lose public assistance for their long-term supports and services. The President is expected to sign this legislation.
The ABLE Act

The U.S. Senate passed the Achieving a Better Life Experience Act (ABLE Act) on December 16, 2014.

The bill as approved will provide a vehicle for some families and people with intellectual and developmental disabilities to save for their future needs.

According to The ARC, “The ABLE Act aims to change the tax code to allow for tax advantaged savings accounts for individuals with disabilities for certain expenses, like education, housing, and transportation. Similar to existing “Section 529” education savings accounts, ABLE accounts would let families save for disability-related expenses on behalf of qualified beneficiaries with disabilities that will supplement, but not replace, benefits provided through the Medicaid program, the Supplemental Security Income program, the beneficiary’s employment, and other sources. If properly managed, funds in the ABLE accounts would not jeopardize eligibility for critical federal benefits. With full understanding of its features, individuals and families could use the ABLE accounts as another tool in planning for the lifetime needs of an individual with long term disabilities. The version of the bill that passed the U.S. House of Representatives includes age limitations and a cap on contributions, added in July by the Committee on Ways and Means to reduce the costs of the bill.”

The President is expected to sign this legislation.

Raymon Harvey Selected as a Best Lawyer 2015

Raymon Harvey Selected as a Best Lawyer 2015

IMG_8761Raymon Harvey was chosen as a Best Lawyer in America (2015) in the practice of Elder Law.

According to Best Lawyers, its listing is “widely regarded by both clients and legal professionals as a significant honor, conferred on a lawyer by his or her peers”.

Inclusion in Best Lawyers is based entirely on peer-review. The methodology is designed to capture, as accurately as possible, the consensus opinion of leading lawyers about the professional abilities of their colleagues within the same geographical area and legal practice area. Best Lawyers employs a sophisticated, conscientious, rational, and transparent survey process designed to elicit meaningful and substantive evaluations of the quality of legal services. Our belief has always been that the quality of a peer-review survey is directly related to the quality of its voting pool.