Medicare news that may be helpful for many:
The Centers for Medicare & Medicaid Services (CMS) today announced that Medicare is adding coverage for preventive services to reduce obesity. This adds to Medicare’s existing portfolio of preventive services that are now available without cost sharing under the Affordable Care Act. It complements the Million Hearts initiative led jointly by CMS and the Centers for Disease Control and Prevention in partnership with other HHS agencies, communities, health systems, nonprofit organizations, and private sector partners across the country to prevent one million heart attacks and strokes in the next 5 years.
Screening for obesity and counseling for eligible beneficiaries by primary care providers in settings such as physicians’ offices are covered under this new benefit. For a beneficiary who screens positive for obesity with a body mass index (BMI) ≥ 30 kg/m2, the benefit would include one face-to-face counseling visit each week for one month and one face-to-face counseling visit every other week for an additional five months. The beneficiary may receive one face-to-face counseling visit every month for an additional six months (for a total of 12 months of counseling) if he or she has achieved a weight reduction of at least 6.6 pounds (or 3 kilograms) during the first six months of counseling.
Through the end of October, 22.6 million people with Original Medicare have received one or more of the free covered preventive services this year.
One of the best blogs I have found about aging is the New Old Age blog in the New York Times, which recently had a post about hospitalists. Back in the day, if you went to the hospital, you let your primary care physician (PCP) know, and he or she would come see you, and oversee your care while you were in the hospital. Since the 1990s, hospitalists have taken over the care of most people in the hospital. Hospitalists are often employed directly by the hospital, or they are part of groups that contract with hospitals. This arrangement is nice for the doctor–no office expenses, regular hours, no on-call, but it may not be so good for the patients, or for Medicare.
As the blogger reports, there are some research studies that indicate that hospitalists are not always beneficial. First and foremost, there is a lack of continuity, because the hospitalist has likely never seen you before. The study also reported that hospitalists save money for hospitals, because patients are discharged sooner, but overall hospitalists cost Medicare money. Why? Because those patients who are discharged sooner are often discharged too soon, and end up back in the emergency room or hospital. The study also found that patients seen by hospitalists were more likely to be discharged to nursing homes, while patients seen by a PCP, who is familiar with the patients’ home and support situation might be more open to discharging the patient home.
The thing to take away from this is that we have to advocate for what is in the patient’s best interest, and provide as much information as possible to all health care providers. We can’t just assume that the doctor knows best, particularly if the doctor doesn’t know you at all.
When in Rome, do as the Romans do. Remember that saying? Rome is an unfamiliar place for many of us, so most of us make arrangements to go to Rome with a tour guide, to show us the ins and outs, and to make sure we have the best experience possible when we go.
Hospitals are also unfamiliar places for many of us, and unfortunately, there aren’t really any tour guides for hire. I will often try to run interference when our Life Care clients go to the hospital, but here are some things to keep in mind if you find yourself or a loved one in the hospital. Lots can potentially go wrong before you are even admitted to the hospital.
I can’t stress how important it is to make sure that Admissions gets all the information on the”face sheet” correct. This is the sheet (or screen, now that more hospitals have electronic records) that has the patient’s contact information, as well as family or other contact information. When I worked in the hospital, this sheet often had wrong information on it. If you have been in that hospital before, the clerk might pull up previous information, and fail to correct it. I just had a client in my office tell me that the nursing home his wife is in had incorrect information, which they got from the previous hospital 9 months ago. That hospital got the wrong information from the hospital before that–even though the husband made sure the correct information got in the system. The problem? The original hospital never removed the paper copies from the medical record at the nurses station, and that copy got sent to every subsequent health care provider.
This same client told me that when he started getting angry phone calls from other health providers claiming he had given them fraudulent information, he found out that the original hospital had made copies of all the insurance cards, but they had never entered the updated information into their computer system. It was the hospital giving out incorrect information, not the client giving out fraudulent information. He had to stand there and watch the clerk key in the updated information to make sure everything was correct.
Driving – that American rite of passage that signals independence more than anything. Do you remember the day you got your driver’s license? I sure do.
However, there comes a time when most of us will have to stop driving. One of my grandmothers voluntarily gave up her license and her car when she realized she could no longer see well enough to drive, and we were all very proud of her for doing so. But for most people, giving up driving is a very difficult decision and a trying conversation to have with our older loved ones.
In Texas, family, friends, a physicians or even an anonymous person can report unsafe driving to the Department of Public Safety, and ask to have a person’s license medically revoked. You can make this suggestion to the Medical Advisory Board at the address on this page. DPS has previously used a form DL-76, which can be found here, although it is not currently available on the DPS website.
The Medical Advisory Board will contact the individual and investigate whether or not a person is able to drive due to a medical condition. This can result in the revocation of a license, either permanently or pending a comprehensive exam. In addition, once a license is revoked, the driver must submit proof of insurance to reinstate his or her license. It may be difficult, if not impossible, to insure a driver who has had his or her license medically revoked.
Another way to have a driver’s license revoked is through a guardianship proceeding. Under Texas law, a judicial declaration of incapacity can revoke a driver’s license. This, however, would be a last resort and should not be taken lightly.
If you need help talking to an older adult about giving up driving, Katten & Benson can assist you. Please give us a call.