Workers' Compensation: Medicare

Showing posts with label Medicare. Show all posts

Wednesday, October 30, 2013

Florida Workers' Compensation Fillings Continue to Decrease

The national trend of far fewer workers' compensation claims is reflected in recent Florida statistics. One must look beyond the statistics and evaluate whether claims are not being filed because they have been regulatorily or statutorily been barred; whether there has been a major decrease in riskier jobs; whether the workplace is actually becoming safer; or whether lawyers are not taking the claims to adjudication because they go uncompensated for their efforts. Perhaps a combination of all. If the claims are not being filing as work related compensable events, where are benefits being sought. One certain path is Medicare and Medicare and Social Security Disability Benefits, especially those with catastrophic injuries. Today's post is shared from Judge David Langham and I would encourage to read his entire blog post on his site at: http://flojcc.blogspot.com/2013/10/annual-reort-installment-petition.html David Langham is the Deputy Chief Judge of Compensation Claims for the Florida Office of Judges of Compensation Claims and Division of Administrative Hearings.

"Petition filings and new case filings continued to decline last year. Remember, the Florida Office of Judges of Compensation Claims (OJCC)(and the rest of the state) runs on a fiscal year, which begins each July 1 and concludes the following June 30. So, fiscal 2013 ended last summer, and the OJCC has been compiling and preparing statistics and measures since then. It is a long process that includes verification of data that our district staff has entered into the database through the year.

"In 2012-13, 58,041 PFB were filed. In 1995-96 the total PFB filing was 56,298. So, after a significant increase in litigation following the 1994 reforms, PFB volumes are approaching the pre-reform volumes. This is an imperfect comparison. Before the 1993 reforms, "claims" were the operative pleading for identifying the dispute, and jurisdiction of this Office over such disputes was effected by filing an "application for hearing" regarding the claim. With this significant change in 1993, it is difficult to compare filing volumes to periods before 1993.

Read the post in its entirety by clicking here.

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US Inspector General Wants More Disclosure By Back Surgeons Who Implant their Own Devices

Back surgery is a big business and the selling of implanted medical devices are costly transactions. The US Office of Inspector General has issued a report today that their should be more disclosure to patients when back surgeons implant their own devices.

"PODs have a substantial presence in the spinal device market. PODs
provided devices used in nearly a fifth of the spinal surgeries billed to
Medicare in FY 2011, and over a third of the hospitals in our sample
purchased spinal devices from PODs. Many of these hospitals began
purchasing from PODs after 2009. Also, few hospitals in our sample
required physicians to disclose their ownership in device companies,
such as PODs, to their patients.

"In FY 2012, hospitals that purchased from PODs performed more spinal
surgeries and had slightly more complex spinal surgery caseloads than
hospitals that did not purchase from PODs. After they began purchasing
from PODs, hospitals experienced increased rates of growth in the
number of spinal surgeries performed as compared to the growth rate for
hospitals overall. Determining the cause for the increased rate of spinal
procedures was beyond the scope of our review.

"In addition, our findings raise questions about PODs’ claims that their
devices cost less than other suppliers. Within the device categories we
examined, PODs’ devices either cost the same as or more than devices
from companies not owned by physicians. This, combined with the
volume of spinal surgeries we found at hospitals that purchase from
PODs, may increase the cost of spinal surgery to the Medicare program
and beneficiaries over time. Further, hospitals inconsistently required
physicians to disclose ownership interests in PODs to either the hospitals
or their patients. Thus the ability of hospitals and patients to identify
potential conflicts of interest among these providers is reduced.

"The Sunshine Act may improve the ability of hospitals and patients to
identify physicians’ investment in device companies. The Act will
require most PODs to report to CMS all physician ownership and
investment interests.18 CMS plans to list these companies and their
payments on a publicly available Web site.

Click here to read the complete report.

Friday, October 18, 2013

Huge Differences by Region in Prescribing to Elderly, Study Finds

Researchers find that a higher proportion of seniors are prescribed antidepressants, dementia drugs and other medications in some parts of the country than others. Click to explore the researchers' findings.

Elderly Americans are prescribed medications in inexplicably different ways depending on where they live,according to a new report from Dartmouth researchers.

Th emostdepressed older patients—or at least the ones being medicated -- live in parts of Louisiana and Florida. There’s a cluster with dementia around Miami. And the seniors who have the most trouble sleeping? They live, perhaps unsurprisingly, in Manhattan.

The study by the Dartmouth Institute for Health Policy and Clinical Practice examined geographic variations in the drugs elderly Medicare patients received in 2010. Researchers mapped where patients got medications they clearly needed and where they got drugs deemed risky for the elderly. They also looked at difference sin the use of so-called discretionary drugs, which they say are but of uncertain benefits.

The report’s findings underscore those of a ProPublica investigation in May, which found that some doctors who treat Medicare patients often prescribe drugs that are dangerous or inappropriate for certain patients. ProPublica also found that the federal officials who run Medicare have done little to scrutinize prescribing patterns in their drug program,known as Part D, or question doctors whose practices differ from their peers.
Officials...

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Labor puts Dems on notice: Don’t touch Medicare and Social Security benefits

Today's post was shared by Steven Greenhouse and comes from www.washingtonpost.com

With the crisis chatter in Washington now turning to speculation about the coming budget talks and the possibility of a “grand bargain” to replace the sequester, liberals and unions are getting increasingly nervous that Congressional Dems will give up entitlement benefits cuts in exchange for, well, whatever is on offer from Republicans, which isn’t at all clear.

In an interview, Damon Silvers, the policy director of the AFL-CIO, laid down a hard line, putting Dems on notice that any agreement that cuts entitlement benefits — even in a deal that includes GOP concessions on tax hikes — is a nonstarter. Silvers strongly suggested labor would withhold support in 2014 from any Dem lawmaker who supports such a deal.

“We are opposed to Social Security, Medicare, and Medicaid benefits cuts. Period,” Silvers told me. “There will be no cover for members of either party who vote for such a thing.”

Silvers said the AFL-CIO also opposes the entitlements cuts in the President’s budget, such as Chained CPI and a form of Medicare means testing. It’s unclear how, or whether, those will figure in what Dems bring to the table in the budget talks, which are mandated by the deal just reached to end the crisis.

“Chained CPI is like the vampire of American politics,” Silvers said. “It keeps being shot through the heart and it keeps reviving. The reason it keeps coming back is because it has...

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Tuesday, October 15, 2013

What a Government Default Will Do To Workers' Compensation

With only hours left, and the politicians in Washington DC still unsettled about how to resolve a US credit default, the focus turns to the impact on workers' compensation programs throughout the country.

Expanding on the problems besieging compensation programs following the US Government Shutdown, things are going to get much worse and very quickly. Social Security will stop paying benefits, its contractors and medical providers. Closing down those contributions will literally suffocate transactional information concerning integration of Medicare Secondary Payer Act benefits and reimbursement. Calculating offsets and reverse offsets will become an impossibility. Insurance companies in reverse offset states will be required to fund more dollars into the system as application flow into the state systems to modify prior awards still being paid.

Employers dependent upon government payments, including funding and contracts, will be unable to pay workers and insurance company premiums. Cascading financial distress will implode the economy and unemployment will become rampant.

Additional burdens will be placed upon injured workers who even already are struggling to make ends meet and obtain medical treatment with absolutely no Federal safety net in place to catch them. Injured workers with pending claims will be unable to seek medical and pharmaceutical benefits from collaterally funded programs.

Federal dollars actually fund over 70% on state rehabilitation programs. These programs will quickly dry up, and the those injured workers who are seeking placement in a new job through rehabilitation will be locked out of the states.

Workplaces will continue to be unregulated as OSHA (The Occupational Health Administration) will be unable to financially fund enforcement programs, new safety programs and even review comments for pending regulations, ie. The Smart Act.

Investigations requirement Federal records, including prior military records, will become increasingly difficult to secure. Stalling this process will delay completed workers' compensation medical records, expert evaluation opinions and the adjudication of workers' compensation claims.

Quite a mess! Not a pleasant prospect to look forward to, as the clock keeps clicking down

Wednesday, October 9, 2013

Federal Court Deems CMS Interpretation of the MSP Act Impenetrable

A UD District Court has denied a health provider's challenge to CMS's interpretation of the to the Medicare Secondary Act. CMS's formula for reimbursement was upheld.

"The Court finds this line of argument unpersuasive for several reasons. Most significantly, Allina's heavy reliance on the above-cited cases is unavailing because none of those decisions directly dealt with the precise issue before this Court–i.e., the phrase “entitled to benefits under Part A.” Rather, all of those courts were called upon to interpret the other component of the Medicaid fraction's numerator–the requirement that patients be “eligible” for Medicaid. For this very reason, our Court of Appeals “declined to follow” those same cases, characterizing those courts' discussion of the phrase “entitled to benefits” as dicta. Northeast Hosp., 657 F.3d at 12 n.7. This Court agrees with that assessment and follows the lead of our Circuit. Those decisions do not lend any meaningful support to Allina's arguments here. Moreover, the D.C. Circuit has rejected the substance of this “eligible” versus “entitled” argument as unpersuasive in any event, observing in Northeast Hospital that “the fact that the DSH factions speak of ‘eligibility’ for Medicaid but ‘entitlement’ to Medicare” was not “enlightening.” Id. at 12. Instead, as the Circuit went on to state, “the Secretary's interpretation of ‘entitled’ as ‘meeting the statutory criteria for entitlement’ ... does not actually collapse the terms.” Id. (explaining that an individual could be “ ‘eligible’ for, but not ‘entitled’ to, Part A benefits because one has not yet ‘enrolled’ in the program”). This Court concurs. The Secretary's reading of the statute at issue here does not equate these two terms, and Allina's insistence otherwise lacks merit."

Allina Health System v. Sebelius,

--- F.Supp.2d ----, 2013 WL 5530609, D.D.C., October 08, 2013 (NO. 09-CV-1889 (RLW))

Thursday, October 3, 2013

Many Nursing Homes Operate Without Adequate Sprinkler Systems

Today's post was shared by The New Old Age and comes from newoldage.blogs.nytimes.com

A body was removed from the Greenwood Health Center in Hartford, Conn., after a fire in 2003.

Associated PressA body was removed from the Greenwood Health Center in Hartford, Conn., after a fire in 2003.

Now and then, you learn something about caring for the elderly that stops you in your tracks.

Like this: Until last month, federal regulations did not require all nursing homes to have automatic sprinkler systems.

It’s a bit staggering, isn’t it? Automatic sprinklers, the most effective protection against fires, have been mandated in any new nursing home certified by Medicare and Medicaid, or in new construction added to an existing facility, since 2000. But for older nursing homes, there was no such regulation until August 2008 — and the industry, complaining about high costs, was given five years to comply.

That deadline passed last month, but more than 1,100 older nursing homes still do not have sprinklers or have only “partial” systems, federal records show.

Most of these places have some sprinklers — perhaps only in laundries and kitchens, perhaps in residents’ rooms but not hallways. What “partial” means in this context is unclear, a Medicare spokeswoman told me. But about 125 homes have no sprinklers, including 18 in Illinois, 16 in Texas and 13 in North Carolina. (You can see the list, though it may contain some reporting inaccuracies and may not reflect very recent changes.)

A fire in a nursing home is a horrifying...

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Sunday, September 29, 2013

The Government Shutdown is a Kick-In-Gut to Workers' Compensation

Workers' Compensation programs will be impacted by a Government shutdown because of both the offset provisions of the Social Security Act and the Medicare Secondary Payer Act (MSP). Even The SMART Act, recently enacted to hopefully establish a more efficient collection process will be derailed.

As the US House of Representatives, under Republican leadership influenced by The Tea Party, likened in Aaron Sorkin's HBO program, The Newsroom, as "The American Taliban," passed legislation to shutdown the US Government this Tuesday, serious concern exists as to the consequences of the shutdown on workers' compensation programs throughout the nation.

In many States, whether or not a reverse offset exists, it is essential to determine what a claimant's Average Current Earnings (ACE) are to calculate, and reach a final determination of temporary and permanent disability, in a state workers' compensation claim. The access to those numbers will become difficult to obtain because of administrative rollbacks, and anticipated further delays in claims processing. Even though Federal payments will be forthcoming under protective measures, the claims process will be derailed.

Likewise, the process to obtain conditional payment information will be delayed or non-existent. The provisions of the Medicare Secondary Payer Act mandating reimbursement to The Center for Medicare and Medicaid Services (CMS) will be put on hold. Similarly, reviews for future medical compromises embodied in the Workers' Compensation Medicare Set-aside Agreements (WCMSA) will be delayed just because of administrative cutbacks in the claims system, including the appeals process.

The recently enacted provisions of The SMART Act. long sought by a coalition of cottage industries, and compensation parties, to the reimbursement process itself, will face its first major challenge to implementation as the Internet web-portable becomes non-functional. Recently proposed final Rules will face delay in implementation as the exchange of comments under the rulemaking process become further delayed in the process of submission and response.

Overall, the workers who most need the system to function, and who waited the longest time, in waiting for final adjudication of their claims, will become victim of the process. No matter how long the shutdown extends, the Federal action will highlight the continued deterioration of the complex patchwork process know as workers' compensation. The now antiquated, and once expeditious and remedial insurance system, will have suffered yet another devastating blow in its attempt to survive in a radically changing economic and socio-political system.
....

Jon L. Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 decades the Law Offices of Jon L Gelman 1.973.696.7900 jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.

Saturday, September 28, 2013

Building an Accountable Care Organization and Its Impact on Workers' Compensation

Medical cost containment is a universal problem for insurance companies and employers. For those states with fee schedules indexed to the Medicare system, limitations are in place. For those jurisdiction where fee limitations are not in place, ie. NJ,costs may continue to soar without containment. Today's post was shared by NEJM and comes from blogs.hbr.org

Suppose for a moment that you are an administrator in an organization that provides health care and your job is on the line for delivering both savings and improved care. Because you want to be part of the solution to the health-care-cost problem, you have signed contracts with payers that reward your institution or system for reducing the costs of care. These same contracts require you to pay a penalty if the costs of care go up more than inflation. What would be your first, second, and third move?

This is not a hypothetical question. More than 300 hundred administrators of accountable care organizations (ACOs) across the United States are facing it.

My team at Partners HealthCare in Boston is faced with this exciting (and daunting) challenge. Having signed shared-savings contracts with both commercial payers and Medicare, our CEO, Gary Gottlieb, established a Population Health Management unit. A major focus of our work is to achieve shared savings in our contracts. That means controlling costs for the populations cared for by our primary care physicians. Since doctors and hospitals within Partners bill for a majority of the care these patients receive, you could say our success depends on reducing the income of our colleagues. Harvard Business School’s Clayton Christensen has taught us this is not possible — that an organization will not cannibalize itself.

So when we go knocking on...

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Friday, September 27, 2013

Lobbying In D.C. On Behalf Of Injured Workers

Regulations were proposed recently to operationalize the The SMART act. The public comment period is ongoing. Today's post comes from guest author Paul J. McAndrew, Jr., from Paul McAndrew Law Firm.

On April 17, my colleagues from WILG (Workers Injury Law & Advocacy Group) and I gathered in Washington D.C. to lobby Congressional representatives on behalf of injured workers. We discussed several bills that will affect the interests of workers in Iowa and across the United States. I had the pleasure of meeting with Senator Tom Harkin, Senator Chuck Grassley, Congressman Bruce Braley and Congressman Dave Loebsack in their offices where we discussed the following bills:

The MSP and Workers’ Compensation Settlement Agreement Act of 2012

The Akaka Amendment to S. 1789, The Post Service Reform Bill (an amendment to strip from S. 1789 those provisions that deform the Federal Employee Compensation Act).

As I explained at these meetings, the MSP and Worker’s Compensation Settlement Act of 2012 is necessary for three reasons:
(1) to bring some reasonable and understandable system to CMS’ current uncertain and regulation-less system of establishing Medicare Set-aside Plans for workers’ compensation settlements;
(2) to allow for an appeal of CMS’s MSA determination; and
(3) to bring some reasonable time limits to CMS’ process of setting the MSA required for workers’ compensation settlements.

The Akaka Amendment to strip the FECA deform provisions out of S.1789 is necessary because the FECA deform provisions wrongfully reduces monetary benefits and treats the injured worker like a fraud (mandating period independent medical examinations, vocational rehabilitation and field nurses to hound the injured worker). Workers' compensation reform is a constant threat to the rights of workers across the country. It is important that all of us who participate in the work' comp' system do our part to protect and preserve these legal rights.

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Monday, September 23, 2013

CMS Publishes Rules to MSP Payments Under the SMART Act

Medicare has published proposed Rules to governor obtaining information concerning the conditional payments as required by the recently implemented SMART Act. The Regulations expand the bureaucratic framework for Medicare beneficiaries and their representatives in order to obtain and appeal information on condition payment demands from the government.

The Rules are effective on November 10, 2013 and the comment period closes at 5pm on that date.

The government will be establishing a multifactorial implementation process to keep information secure: DX Codes, provider names. dates of service and conditional payment amounts. Ultimately, it appears that the process will be yet another hurdle to obtain information for workers' compensation claims and release the beneficiary from government liability for medical expenses.

The proposed CMS Rules can be reviewed at: https://www.federalregister.gov/articles/2013/09/20/2013-22934/medicare-program-obtaining-final-medicare-secondary-payer-conditional-payment-amounts-via-web-portal

….

US Supreme Court Asked to Review MSP Preemption Issue (workers-compensation.blogspot.com)
9th Circuit Vacates MSP Injunction Against CMS for Medicare Reimbursement (workers-compensation.blogspot.com)
Medicare To Punish 2,225 Hospitals For Excess Readmissions (workers-compensation.blogspot.com)
The Public and the Conflict over Future Medicare Spending (workers-compensation.blogspot.com)
Democrats Jump on the 'Death Panel' Bandwagon (workers-compensation.blogspot.com)

Saturday, September 21, 2013

Health Spending Over The Coming Decade Expected To Exceed Economic Growth

Today's post was shared by Kaiser Health News and comes from www.kaiserhealthnews.org

The nation’s total health spending will bump up next year as the health law expands insurance coverage to more Americans, and then will grow by an average of 6.2 percent a year over the next decade, according to projections released Wednesday by government actuaries.

That estimate is lower than typical annual increases before the recession hit. Still, the actuaries forecast that in a decade, the health care segment of the nation’s economy will be larger than it is today, amounting to a fifth of the gross domestic product in 2022.

They attributed that to the rising number of baby boomers moving into Medicare and the actuaries’ expectation that the economy will improve, according to their findings published in the journal Health Affairs.

The actuaries were not persuaded that experiments in the health law and new insurer procedures that change the way doctors, hospitals and others provide services will significantly curtain health spending.

They assumed "modest" savings from those changes from the law. "It's a little early to tell how substantial those savings will be in the longer term," Gigi Cuckler, one of the actuaries, told reporters.

The actuaries also said they are skeptical that the nation has entered a new era of lower health spending, a case that has been made by the Obama administration and many prominent economists. They have predicted a strengthening economy will not be accompanied by sharp health spending hikes. The report expects health...

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Law Will Shift Demographics For Medicaid Toward Healthier Group, Study Finds (workers-compensation.blogspot.com)
No Shopping Zone: Medicare Is Not Part Of New Insurance Marketplaces (workers-compensation.blogspot.com)
For Workers Leaving Their Jobs, Health Exchanges Offer Insurance Choices Beyond COBRA (workers-compensation.blogspot.com)
A Conservative Re-Envisioning Of The Health Care Overhaul (workers-compensation.blogspot.com)
GOP Still Embroiled In Intra-Party Split Over Govt. Shutdown And Efforts To Defund The Health Law (workers-compensation.blogspot.com)
Medicare To Punish 2,225 Hospitals For Excess Readmissions (workers-compensation.blogspot.com)

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Saturday, September 14, 2013

The Public and the Conflict over Future Medicare Spending

Medicare will govern the at least the cost of workers' compensation medical delivery benefits. Today's post was shared by NEJM and comes from www.nejm.org

Two recent government reports show substantial short-term improvements in the financial outlook for Medicare and in the federal budget deficit.1,2 However, these forecasts also suggest the need for further action brought about by a worsening of the financial situation after 2015 as the number of Medicare recipients increases from 52 million to 73 million in the decade following.1-3 This issue is likely to receive considerable attention in the upcoming debate about the federal budget deficit and the national debt.

As we reported in the Journal in 2011, there has been little public support for major policy changes aimed at reducing Medicare spending to lower the federal deficit.4 This article goes further and seeks to document the underlying beliefs that may shape the public response to future efforts to substantially slow projected Medicare spending. Our thesis is that there exists today a wide gap in beliefs between experts on the financial state of Medicare and the public at large. Because of the potential electoral consequences, these differences in perception are likely to have ramifications for policymakers addressing this issue.

We examine this thesis by analyzing data from six public opinion polls conducted in 2013 with 1013 to 2017 U.S. adults, plus historical data, in a project supported by the Robert Wood Johnson...

Robert J. Blendon, Sc.D., and John M. Benson, M.A.

N Engl J Med 2013; 369:1066-1073September 12, 2013 DOI: 10.1056/NEJMsr1307622

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The 10 Highest Medical Cost Jurisdictions for Medicare (workers-compensation.blogspot.com)
No Shopping Zone: Medicare Is Not Part Of New Insurance Marketplaces (workers-compensation.blogspot.com)
Democrats Jump on the 'Death Panel' Bandwagon (workers-compensation.blogspot.com)
Medicare To Punish 2,225 Hospitals For Excess Readmissions (workers-compensation.blogspot.com)
US Supreme Court Asked to Review MSP Preemption Issue (workers-compensation.blogspot.com)
9th Circuit Vacates MSP Injunction Against CMS for Medicare Reimbursement (workers-compensation.blogspot.com)

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CA's New Rate Filing Reflects Uncertainty

Today's post was shared by WorkCompCentral and comes from daviddepaolo.blogspot.com

The political grandstanding that is typical this time of year when the California Workers' Compensation Insurance Rating Bureau publishes is pure premium rate request should be boisterous.
The WCIRB's Governing Committee yesterday voted unanimously to approve a 2014 advisory pure premium rate of $2.70 per $100 of payroll.

This is 3% more than the $2.62 rate the committee approved in August and is 6.9% higher than the average insurer filed rate of $2.53.

And even then rates may be inadequate to cover loss developments according to members.
The combined ratio remains well north of 100%.

Much of the uncertainty stems from the pending conversion to the Resource Based Relative Value Scale for physician reimbursement.

Estimates on the impact of the conversion range from no impact to an increase of up to several hundred million dollars.

The reason for the vagueness is that there are codes in the current system that have not yet been "cross talked" to the RVRBS.

Adding to the complexity is that for unknown reasons claim frequency has been climbing.
Increased frequency and medical loss-cost development that was observed in data collected through the end of June accounts for more than two-thirds of the proposed rate increase. (About 2% of the increase for 2014 is attributed to higher permanent disability benefits.)

Some suspect this is due to resolution of complex older claims that had been languishing because of Medicare set-aside requirements as well as the nature of the injuries.
Since...

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Listen to the GAO Podcast: Social Security Administration Improper Disability Insurance Payments

Social Security Administration Improper Disability Insurance Payments

Click here to listen

SSA's DI program is the nation's largest cash assistance program for workers with disabilities. Though program rules allow limited work activity, some work activity indicates beneficiaries are not disabled and therefore not entitled to DI benefits. Consequently, SSA might overpay beneficiaries if the agency does not detect disqualifying work activity and suspend benefits appropriately.

GAO was asked to study potential DI overpayments. GAO examined the extent to which

(1) the NDNH indicates that individuals received potential DI overpayments; and

(2) SSA's enforcement operation detects potentially disqualifying work activity during the waiting period.

GAO drew random, generalizable samples of individuals from those whose earnings on the NDNH were beyond program limits and compared wages from their employers to DI program data to identify potential overpayments. To illustrate the circumstances in which SSA made potential DI overpayments, GAO reviewed case files for a nongeneralizable selection of six individuals--three who worked during their waiting period, and three who received potential overpayments for at least 3 years.

Recommendation: To improve SSA's ability to detect and prevent potential DI cash benefit overpayments due to work activity during the 5-month waiting period, the Commissioner of Social Security should assess the costs and feasibility of establishing a mechanism to detect potentially disqualifying earnings during all months of the waiting period, including those months of earnings that the agency's enforcement operation does not currently detect and implement this mechanism, to the extent that an analysis determines it is cost-effective and feasible.

Related articles

Thursday, September 12, 2013

Getting While the Getting Is Good

Preparing for disability can only go so far. Sometime pre-emptive action needs to be taken. This is an example of what aging workers need to consider. Today's post was shared by The New Old Age and comes from newoldage.blogs.nytimes.com

“Don’t wait for a crisis,” I told a friend whose elderly parents were struggling to care for themselves and a big Connecticut home.

“Don’t wait for a crisis,” I told another friend, his mother recently widowed, lonely and overwhelmed, rattling around in a family house that was now her solo responsibility.

“Don’t wait for a crisis,” I told a third friend, whose widowed father-in-law dropped his daily insulin regimen after his live-in girlfriend left him.

“Don’t wait for a crisis,” I’ve told readers of “The New Old Age,” no doubt ad nauseam.
As just about everyone who has cared for an aging parent knows, getting old is both an inexorable and maddeningly unpredictable forward march. Everything is OK. Then it’s not. Then it is again. What felt early on like a roller coaster becomes the new normal. In between swerves and plummets, it is almost possible to doze off.

And planning for all possible eventualities is useless — after the essential documents are in place, the family has talked openly and often about end-of-life wishes, they understand the difference between Medicare and Medicaid, they know how much money is available and that it is probably not going to be enough.

Caregivers and their elderly charges both know, in a spoken or unspoken way, that on the horizon is The Crisis. That’s the one that demarcates “before” and “after.” Your parents...

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Wednesday, October 30, 2013

Florida Workers' Compensation Fillings Continue to Decrease

Thursday, October 24, 2013

US Inspector General Wants More Disclosure By Back Surgeons Who Implant their Own Devices

Friday, October 18, 2013

Huge Differences by Region in Prescribing to Elderly, Study Finds

Labor puts Dems on notice: Don’t touch Medicare and Social Security benefits

Tuesday, October 15, 2013

What a Government Default Will Do To Workers' Compensation

Wednesday, October 9, 2013

Federal Court Deems CMS Interpretation of the MSP Act Impenetrable

Thursday, October 3, 2013

Many Nursing Homes Operate Without Adequate Sprinkler Systems

Sunday, September 29, 2013

The Government Shutdown is a Kick-In-Gut to Workers' Compensation

Saturday, September 28, 2013

Building an Accountable Care Organization and Its Impact on Workers' Compensation

Friday, September 27, 2013

Lobbying In D.C. On Behalf Of Injured Workers

Monday, September 23, 2013

CMS Publishes Rules to MSP Payments Under the SMART Act

Saturday, September 21, 2013

Health Spending Over The Coming Decade Expected To Exceed Economic Growth

Saturday, September 14, 2013

The Public and the Conflict over Future Medicare Spending

CA's New Rate Filing Reflects Uncertainty

Listen to the GAO Podcast: Social Security Administration Improper Disability Insurance Payments

Social Security Administration Improper Disability Insurance Payments

Thursday, September 12, 2013

Getting While the Getting Is Good

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