Medicare Watch

Health Reform Q&A

Q: Is there any truth to the story that older citizens will be REQUIRED to receive end-of-life counseling?

Q: I am 67 years old and not in the best of health. Here is my question: Is the ACA planning to put people in my group out to pasture? I have heard of end-of-life counseling, and I am not really thrilled with this program. Is this real, or is it a myth?

A: Under Medicare and the Affordable Care Act (ACA), no one is “put out to pasture,” and no one is required to get counseling. That is one of the most damaging and frightening myths that have been targeted at the Medicare population. We at the Medicare Rights Center have read the law, and we confidently assure our readers that the Affordable Care Act does nothing of the sort. 

This myth began with a distortion of a provision in an early version of the proposed bill for optional advance care planning. The provision was later stripped from the law. Advance care planning allows patients the opportunity to talk to their doctors about their personal preferences regarding the spectrum of care available to them at the end of life. This includes the use of advance directives, which can state whether a person does or does not wish to receive life-sustaining treatment. Advance directives are included in medical files so that no matter where patients receive care, their wishes can be honored. The program, had it become law, would have provided support for patients to talk with their doctors about where they would most like to receive care. At the core of advance care planning is a respect for patient choice. But the program would not have changed the current standard of care, which is to provide life-sustaining treatment unless the patient or the patient’s representative, in many cases a family member, has indicated otherwise. Regrettably, Medicare consumers will have limited access to such counseling because the proposal was mischaracterized and, as a result, eliminated. 

Unfortunately, a lot of misinformation about the contents of the health reform bill circulated before it passed, and much of this misinformation is still prevalent today. This type of misinformation is harmful to people with Medicare, which is why we feel it is important to address these questions, and why we are happy when readers seek answers. 

Learn more about advance directives.

Find more resources on advance directives.

Please keep sending us your questions about health reform and Medicare, and look for more answers in upcoming issues of Medicare Watch.

Click here to send us your questions.

We are still looking for stories about health reform and Medicare. If you have received a discount on drugs in the doughnut hole in 2011, or have already visited your doctor for free preventive services or the new annual wellness visit, we want to hear from you!

Click here to share your story.

Finding Savings for Medicare by Fighting Fraud

Targeting Medicare fraud will significantly strengthen the Medicare program’s financial outlook, according to testimony presented at a hearing held yesterday by the House Energy and Commerce Oversight Subcommittee. The General Accountability Office (GAO) released a report in conjunction with the hearing that highlighted areas where the Centers for Medicare & Medicaid Services (CMS) could ramp up fraud-fighting efforts to help prevent improper Medicare payments, which were worth approximately $48 billion dollars last year. There are particularly high rates of fraud among providers of imaging services, home care, nursing home care and durable medical equipment, which includes equipment such as wheelchairs.

However, there has been progress of late. The House Ways and Means Committee held its own hearing on fraud, during which Peter Budetti, deputy administrator and director of the Center for Program Integrity at CMS, provided testimony on how the Affordable Care Act (ACA) strengthens the authority and capacity of CMS and the Department of Justice (DOJ) to fight fraud within Medicare. For example, the ACA requires more stringent screening requirements of Medicare providers and creates a centralized database of claims information that can be utilized across agencies. The hearings follow an active February for law enforcement agents working on Medicare fraud. On February 11, the Medicare Fraud Strike Force charged 111 individuals across the country for alleged involvement in a Medicare fraud ring that perpetrated $225 million in false billing to Medicare. 

Read the GAO report.

Read Deputy Administrator Peter Budetti’s testimony.

Read more about Medicare fraud and recent activities of the Medicare Fraud Strike Force.

Medicare Reminder

Medicare will cover certain types of medical equipment, as long as the equipment is: 

• able to withstand repeated use;
• primarily and customarily used to serve a medical purpose;
• generally not useful to a person in the absence of an illness or injury; 
• appropriate for use in the home; and
• provided by specific suppliers that are approved by Medicare.

Some examples of this equipment are walkers, wheelchairs, power scooters, hospital beds, home oxygen equipment, diabetes self-testing equipment (and supplies) and certain nebulizers and their medications (nondisposable).

Learn more about durable medical equipment at www.MedicareInteractive.org.

 

Spotlight

A program to bolster health coverage for early retirees disbursed more than $535 million to private employers last year, according to a report released by the Department of Health and Human Services (HHS). Created by the Affordable Care Act, the program has helped preserve access to care for millions of older adults.

Read HHS’s press release.