Articles Tagged with New York Medicaid attorney

The New York Department of Financial Services recently published a proposal to add a “best interest” standard to insurance regulations that imposes suitability requirements on annuity recommendations by producers and insurers in New York. The move comes soon after the National Association of Insurance Commissioners (NAIC) suitability working group issued its own proposed guidelines for best interest standards for the NAIC Model Suitability Regulation which seeks to create a national standard for insurance regulations.

The proposals would require that an annuity purchase and replacement recommendation not only be suitable but also be in the best interest of the consumer at the time the recommendation is made. The proposal defines “best interest” as “acting with reasonable diligence, care, skill and prudence in a manner that puts the interest of the consumer first and foremost” and does not necessarily mean the cheapest policy available.

Although the proposed NAIC models are only recommendations to state regulators overseeing their respective insurance markets, they are nonetheless important because many professional organizations rely on these private interest groups for guidance on how to conduct their business. New York is one of the majority of state that already have adopted laws requiring insurance producers to make “suitable” annuity purchase recommendations and require insurers to maintain supervision systems designed to ensure compliance with regulations.

Promising statistics recently came out early this year indicating the mortality rate for older Americans is down from 2015 to 2016, perhaps due in part to the greater access to healthcare our elders enjoy now that insurance companies cannot deny individuals with pre-existing conditions. For Americans age 75 to 84, the mortality rate improved by 2.3 percent between 2015 and 2016, or twice the rate of improvement seen between 2011 and 2016. The figures come from the Society of Actuaries and is based on data provided by the Centers for Disease Control.

Mortality also improved for those 85-years and older by 2.1 percent, which is more than three times the rate of improvement between 2011 and 2016, according to new analysis from the Society of Actuaries. However, Americans aged 25 to 34-years old saw their mortality rates increase by 10.5 percent in 2016 which represented the highest of all age brackets.

The Society of Actuaries believes the uptick in mortality rates for younger Americans is due to a spike in accidents and the nationwide opioid epidemic. According to the report, opioid deaths are up almost 25 percent across the country in 2016, which constituted the highest increase for any single type of death.

The White House recently announced it planned to scale back initiatives put in place by the previous administration to reduce wasteful spending created by the complexities of the country’s healthcare system. As a result, officials from the Center for Medicare and Medicaid Studies (CMS) said they will no longer be operation on an aggressive timeline put in to place which sought to link increases in Medicare payments based on the quality of care patients received from hospitals which received the funding.

The objective of the direction taken by the Obama administration was to overhaul the nation’s largest health care program by altering payments to doctors and hospitals so that these providers would be incentivized to reduce unnecessary services that can put a drain on resources. The hope was that doctors would coordinate patient care, resulting in lowering healthcare costs while still maintaining vital revenue streams from Medicare that providers rely upon to do business.

To reach that goal, officials announced back in 2015 that in just three-years, half of Medicare payments to hospitals would be tied to standards on patient quality of care. However, White House officials recently told some news outlets that the new administration would instead conduct a review of how well the plan did or did not work at achieving this goal. While the Trump administration is not likely to fully do away with the initiatives, it is unlikely the proposed timeline will remain in place.

A recent audit conducted by the Social Security Office of the Inspector General found that the program has failed to fully pay the overwhelming majority of surviving spouses entitled to receive survivor benefits in addition to the regular Social Security benefits. According to the report, the Social Security Administration shorted $131 million to over a combined 9,000 widows and widowers aged 70 and older, or about 82 percent of those eligible.

The issue stems from a provision passed in the Bipartisan Budget Act of 2015 which ended the so-called “file and suspend” strategy which activates one spouse’s monthly benefit and suspends the other’s in order to increase payments on the delayed account after the individual reaches 70-years old. The members of Congress who passed the bill did so under the assertion those types of provisions constitute loopholes that unfairly increase payments to married couples.

However, the law was never meant to impose restrictions on couples filing a restricted application for survivor benefits where beneficiaries elect to claim their survivor benefits and delay taking their own Social Security benefits until the age of 70. This allows the widow or widower to grow their own Social Security benefits by 8 percent annually up until he or she reaches the age of 70. For those who are aware of the opportunity and take advantage of it, the increased benefits can make a tremendous difference in quality of life.

When someone passes away, he or she typically designates an individual as the executor of the estate in a last will and testament. As the executor of the estate, that individual has tremendous responsibility to fulfill his or her duty to the deceased and carry out that person’s final wishes to distribute property as desired. Unless executors fully embrace their responsibility to act as the representative of an estate and gather all the necessary documentation, complications can arise that may delay what should otherwise be a relatively simple process.

One of the most important primary steps the executor of the estate will have to take is filling the estate with the appropriate probate court in New York State. The proper venue is in the probate court of the county where the deceased lived or intended to return to if he or she was away from their residence at the time of death. If the will is filed with the wrong probate court, the judge hearing the case will likely be forced to reject the will’s entrance to probate.

If the deceased had more than one home, the proper county would be the one where the individual primarily lived or intended to live before passing away. Often times, older people live out their final days in nursing homes or assisted living facilities in counties outside of where there home actually is. Again, the proper jurisdiction to file probate would be where the person lived or would have lived had he or she not been a resident at the nursing home or assisted living facility.

When someone dies, a death certificate records on paper the time and place where the decedent passed away. While the funeral director where you lay your loved one to rest will usually obtain several copies for your records, it may be necessary to obtain a certified copy that has a raised seal and can be used for matters like settling an estate or claiming insurance benefits.

If someone passes away in New York City, Bronx, Brooklyn, Manhattan, Queens, and Staten Island, you can obtain a copy from the New York City Office of Vital Health either online or through the mail. If the decedent passed away outside of New York City but in the state of New York, you can order a certified copy of the death certificate online or by mail from the New York State Department of Health.

It is important to note that death certificates can take anywhere from three to four weeks to receive once ordered and are comprised of two parts: the standard certificate of death and the confidential medical report detailing the cause of death. To obtain the confidential medical report with the death certificate, you must be a relative of the deceased. That person can be: a spouse, domestic partner,parent, child, sibling, grandparent, grandchild, informant listed on the certificate, or person in control of disposition.

In a rare showing of bipartisanship, Congress finally passed a long term budget to keep the federal government open and fund everything from the military to vital healthcare programs millions of Americans rely upon to survive. Additionally, the new budget included provisions to shore up issues with Medicare that often put seniors in a terrible financial bind when it came time to paying for their prescription medications.

One of the biggest changing coming to Medicare is the so-called “donut hole” in coverage that can leave seniors on the hook for thousands of dollars in out of pocket costs until the program’s catastrophic coverage kicks in. Medicare Part D is a discount on name brand and generic prescription drugs with several phases that is usually not a problem until spending limits hit certain thresholds. Furthermore, drug companies offer certain discounts through the program that help make vital drugs affordable.

During the initial deductible phase, beneficiaries pay all of their drug costs until they reach the deductible, typically a few hundred dollars. After that, beneficiaries enjoy the initial coverage phase where they are responsible for only a 25 percent co-pay until they reach the current $3,700 limit. While this seems like an ample amount of money for some to cover a year’s worth of drugs, many seniors can quickly reach this limit and enter the “donut hole” coverage gap where out of pocket expenses skyrocket to a copay as high as 50 percent.

As part of recent measures to protect the Social Security numbers of Medicare beneficiaries, the Center for Medicare and Medicaid Studies (CMS) has issued new Medicare ID cards with a random, 11-digit number. However, reports suggest scammers are simply retooling their efforts with more creative ways to extract personal financial information from victims, often times posing as a Medicare representative to do so.

According to an article by CNBC, would be scammers are calling Medicare beneficiaries under the guise of offering renewal or replacement of the new ID cards. Scammers will ask victims for payment to process the new ID card even though the cards are free and do not require beneficiaries to take extra steps to obtain. The scam sounds simple but believable enough to victims who do not want to interrupt their vital healthcare services.

Other scams aimed at Medicare beneficiaries include fake representatives trying to upsell Part D prescription drug coverage under the threat of the individual losing his or her Medicare coverage altogether. Beneficiaries should know that Part D prescription drug coverage if voluntary and not required to maintain benefits. While some scams attempt to fool Medicare beneficiaries into handing over a cash payment, others involve full fledged identity theft.