Critter Corner: A New Scam Targeting Victims of Scams

Dear Commander Bun Bun,

On Tuesday, I read Mr. Farr’s article about the marriage scam, and was upset to see this is happening. I wanted to tell you about another instance in which my grandmother was scammed out of her money, not once—but twice! It was by someone offering to help her get her money back from the first scam. Do you know anything about this new scam, so others can be warned?

Thanks for your help!

Nadja Stwanz

—–

Dear Nadja,

Some older consumers are being conned TWICE by so-called asset-recovery companies promising to help recover the money lost in the initial fraud, the Consumer Financial Protection Bureau (CFPB) warns.

Many don’t realize that anyone can file complaints to regulators, such as the Federal Trade Commission, at no charge. Fraudulent asset recovery companies are charging hundreds or thousands of dollars up front but offer services such as these, that victims could do on their own for free.  In many cases, they even file claims that are too old to be legally valid or don’t have the right documentation. To bait victims, many of them claim to have contacts at government agencies that could help recover money, but warn the victim to keep this information secret.

The scheme came to the CFPB’s attention after it received about 400 complaints in recent months concerning consumers on whose behalf one Florida-based company had filed complaints, according to Stacy Canan, deputy assistant director of the CFPB’s Office for Older Americans. The asset-recovery company wasn’t authorized to file the complaints for these consumers, who were all older than 62 and had been victims of previous scams, such as bogus timeshare investments and work-at-home schemes, Canan says. The CFPB contacted some of the consumers, who said they were unaware the company had filed the complaints on their behalf.

It’s unclear how these asset-recovery companies identify people who have already been victims of scams. The asset-recovery company could be the same group that defrauded the person in the first place. Or it could be that the names of victims were added to a “suckers list” and sold to different con artists.

And why are these consumers falling victim again? A recent study funded by AARP and conducted by psychologists at Stanford University found that consumers who are in a heightened emotional state — common after being scammed — are more vulnerable to deceptive sales pitches. “This is another reason why we think the reload pitch is so successful,” Doug Shadel of AARP says.

The CFPB said there are some red flags consumers should watch out for, such as:

•   companies asking for a fee up front to recover lost money;
•   a demand for secrecy;
•   claims that a company has special government access for filing complaints.

Canan reiterates that “(i)t’s important for consumers to know [that] submitting a complaint with the CFPB or the FTC is free — absolutely no charge,” Canan says.

Hope this is helpful and that your grandmother is never the victim of a scam again!

Commander Bun Bun

Her Hospital Bracelet Said She Was “Admitted.” But We Found Out After Her Discharge That She Wasn’t.

This question was sent in by J.R., in response to my article about observation status in the March 2016 Golden Gazette.  See also our recent blog posting on this topic:  http://www.farrlawfirm.com/medicare/is-it-the-end-for-observation-status

Q. My 89-year old mother (in PA) recently fell injuring her hip and was taken to a local hospital. After being assessed by her doctor, she was told that no surgery was necessary, but that she would be in the hospital for a few days, and then would go to rehab.

Unbeknownst to the doctor and my brother who was visiting her, she was never actually admitted to the hospital, but was in observation status, even though her wristband had the word “admitted” clearly printed on it.

After 3 days, she was told that she was discharged and to go home. My brother and the doctor were completely unaware that she was leaving, and were both upset about the lack of information.

Ultimately, she was out several thousand dollars, because she had to pay for the rehab, as it wasn’t covered by Medicare because she wasn’t actually admitted as an inpatient for at least three days. When asked, the case manager said that just because it says “admitted” on the hospital bracelet, doesn’t mean that she WAS admitted as an inpatient.

Is this standard practice – a wrist bracelet that says “admitted,” when you’re not actually admitted? Why aren’t they required to print, “in observation” or something like that on the bracelet? Or are they?

In the end, she is doing well at home, but is now out a sizeable amount of money for her stay in rehab.

Thanks again for your article and your time.

A. I’m sorry to hear about your family’s experience. Unfortunately, I have heard from many families in similar situations that although you may be in a hospital gown with an ID bracelet, receiving hospital care, and potentially spending a night or two under observation, you still may not be considered an inpatient.

Why? Even though the doctors and nurses are the ones who fill out the charts and provide you with a bracelet, the decision about whether to officially “admit” you is out of the attending health care worker’s control. Ultimately, whatever the nurse or doctor writes down on a patient’s chart has to go past a review committee, which usually uses “clinical-decision support” software to make these decisions. And, hospitals are allowed to place patients in observation at any time during their hospital stay — even retroactively.

The practice “doesn’t make any sense” because people only go into the hospital when they’re sick, Judith Stein, Executive Director of the Center of Medicare Advocacy, says. “They [go] either on orders of a doctor or because, having arrived at the emergency department, they were told they should stay.” And yet, she adds, “those who ended up in the nursing home with no payment were not aware — and neither were their families — that they were in observation status until they were discharged from the hospital. And then they were informed.”

The Requirement to be Informed

Hospital staff are required to inform patients of their status before they leave the hospital.

In August 2015, President Obama signed a bill into a law that requires hospitals to notify Medicare beneficiaries when they have been put under observation status, rather than being admitted to the hospital.

The Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act requires hospitals to notify beneficiaries receiving observation services for more than 24 hours of their status as an outpatient under observation. Under the NOTICE Act, the notification from the hospital must:

  • Explain the individual’s status as an outpatient and not as an inpatient and the reasons why;
  • Explain the implications of that status on services furnished (including those furnished as an inpatient), in particular the implications for cost-sharing requirements and subsequent coverage eligibility for services furnished by a skilled nursing facility;
  • Include appropriate additional information;
  • Be written and formatted using plain language and made available in appropriate languages; and
  • Be signed by the individual or a person acting on the individual’s behalf (representative) to acknowledge receipt of the notification, or if the individual or representative refuses to sign, the written notification is signed by the hospital staff who presented it.

The NOTICE Act is not yet in affect, but several states have their own laws requiring hospitals to inform patients about their status.

Although the federal law won’t go into effect until next summer, a handful of states have already written laws of their own requiring hospitals to notify patients of their status. In J.R.’s situation in our question, his mother should have been given notice of her status, since several states including Pennsylvania, Virginia, Maryland, New York, and Connecticut already required to inform patients about their observation care status.

Appealing the decision

In this case, J.R.’s mother did not want to go through the headache of appealing the decision. However, if you are kept in observation status and transferred to a nursing home and denied coverage by Medicare, the initial steps of the appeals process are pretty simple. In order to appeal, you must wait for your Medicare Summary Notice (MSN) to arrive. Copy the notice and highlight the disputed charges. The notice should provide information on where to send it to request an appeal. You can appeal both the hospital’s denial of hospital admission as well as subsequent the nursing home charges. For more information about the Medicare appeals process, click here.

What to do in the future

In the future, if you or a loved one are in the hospital for any length of time, ask hospital personnel what your status is. Keep asking because it can be changed from day to day. If you are told you are in the hospital under observation status, you can ask the hospital doctor to be admitted as an inpatient and explain the medical reasons that you need to be admitted. This will not guarantee anything, but it can’t hurt.
If, after discharge, you need rehab or other kinds of continuing care but learn that Medicare won’t cover your stay in a skilled nursing facility, ask your doctor whether you qualify for similar care at home through Medicare’s home health care benefit, or for Medicare-covered care in a rehabilitation hospital.

Medicaid Planning in Virginia and other States.

What if your mother needs long-term nursing home care (which costs $10,000 – $14,000 a month in the Metro DC area)? To protect her hard-earned assets from these catastrophic costs, the best time to create her own long-term care strategy is NOW. Generally, the earlier someone plans for long-term care needs, the better. But it is never too late to begin the process of Long-term Care Planning, also called Lifecare Planning and Medicaid Asset Protection Planning.

If you have a family member nearing the need for long-term care in Virginia, Maryland, or DC or already getting long-term care, or if you have not done Long-Term Care Planning, please call us as soon as possible to make an appointment for a no-cost initial consultation:

Fairfax Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Rockville Elder Law: 301-519-8041
DC Elder Law: 202-587-2797

Guess What! I’m Getting Married!

When you see a subject line like this one, you may have several different reactions. The first one that comes to mind is happiness for the couple who is planning to share their life together. The second may be shock or even suspicion, because it seemed to have come out of nowhere, or because the person getting married is a disabled or vulnerable elderly person.

Do you have a loved one who is involved with a younger person and/or has announced he or she is getting married unexpectedly? At first sight, it’s hard not to think the younger spouse is in it for the money. Although true love does prevail in some cases, marrying for money can often be a scam is a form of elder abuse that is spreading throughout the United States. And, unfortunately, the anonymity of the internet makes it a perfect place for con artists to hide their real intentions while trying to entrap their victims under the guise of romantic interest.

So when it comes to your elderly or disabled loved ones, you have to be vigilant. These are some red flags that you and your loved one should look out for when he or she is embarking on online dating for the first time:

Red Flag #1: If someone is too interested – too quickly – in getting to know you beyond the safety of your computer, this could indicate a problem. If you have just met someone online and they are trying to encourage a meet-up before you really know them, they may not just be overly eager.

• Remember that when you give out your number, unless it is an unlisted number, you are giving out your address as well. People can easily do a reverse look-up on a phone number and see where you live. Whether their purpose is dangerous or just desperate, you want to steer clear of both of these.

Unfortunately, there is no federal regulation on elder abuse when it comes to marriage. This is a state-to-state issue that is mainly determined by the capacity of the individual at the time he or she entered the marriage.

Luckily, there are things you can do to help a loved one who you think could be the victim of a marriage scam or to help keep them from becoming one, as follows:

6. Stay vigilant for signs of stress or loneliness, especially after the death of a loved one. In some cases, even if someone seems to be well, he or she may have more dementia, stress, and grief issues than he or she would admit to. Please read our blog post on “Overcoming Loneliness and Depression” for details on recognizing and dealing with these things.

7. Suggest that your loved one protect him or herself. In one instance, an elderly father became involved with the caregiver of his late wife and bought her a car as well as things for her kids. His son admitted that it was his dad’s money and if it made him happy to do this, then he was okay with it. However, he was afraid that his father’s new wife would get him to sign his home over to her and his father could end up homeless. His son shared his concerns with his father and suggested that he put his home in a trust so that it couldn’t be touched or signed away. The father agreed and was confident he had done the right thing one he signed the asset protection trust we drafted.

Critter Corner: How Presidential Candidates Stack Up When it Comes to Pets

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Part 2: Where Presidential Candidates Stand on Medicaid and Veterans Issues

Q. I am having a hard time following where the candidates stand on Social Security, Medicare, and Medicaid. I watched all the debates so far, and typically vote based on the person, not the party. If you know more about their stances on these issues, can you provide an apples-to-apples view on where they all stand, so I can make an informed decision. Thanks very much for your help!

A. When it comes to Social Security, Medicare, and Medicaid, there are clear differences between the Democratic and Republican candidates. Medicaid, in particular, has been an ongoing topic of debate in the 2016 Presidential campaign. Veteran’s issues are also important to many of us, and have been addressed by the candidates in debates, interviews, news articles, and more. Last week, we looked at the candidate’s views on Medicare, the Affordable Care Act, and Social Security. Today, we will examine the positions taken by the leading 2016 presidential candidates on Medicaid and Veteran’s issues, using the chart below. Again, for Republicans, we will focus on the top 4 candidates, based on the most recent polls. Information in the chart is derived from OntheIssues.com, various articles for which I provided the links, and candidate’s websites.

Candidate
Issue
View
 Democrats

Hillary Clinton
Medicaid

Veterans

Bernie Sanders
Medicaid
Sanders says, “Don’t Cut Medicaid.” Watch his video here.

Veterans

Republicans

Donald Trump
Medicaid
Notably, Trump is the only republican candidate who vows to expand economic growth enough that cuts in Medicaid will be unnecessary. Trump discusses Medicaid in his announcement speech in Time magazine.

Veterans
In a USA Today op-ed, Trump said his “record of veteran support is well-documented. I served as co-chairman of the New York Vietnam Veterans Memorial Commission and was responsible, with a small group, for getting it built.”Leader of New York Veterans Group Defends Donald Trump 

ABC News – Jul 20, 2015 

According to Trump, “(d)uring my entire business career, I have always made supporting Veterans a top priority because our heroes deserve the very best for defending our freedom,” Trump said in a statement on Sunday, pointing to his work on a veterans memorial and as grand marshal of the New York City Veterans’ Day Parade.” Trump Could Bump GOP Veterans Off Debate Stage 

WGBH NEWS – Jul 21, 2015

Ben Carson
Medicaid
Ben Carson said, “More freedom and less government in our healthcare system will mean lower costs, more access, and continued innovation. Read more on his website.

Veterans
According to Carson, “(a)s president, I will direct a fundamental transformation in how we care for and empower Veterans across America, including reforming the Veterans Administration (VA). With our current unprecedented level of American support for better Veterans health care, military transition, education and employment, we will make great strides together.” –Dec 30, 2015 

Ben Carson told WMAL’s ‘Drive at Five Show’ in Washington, D.C. following VA Secretary Shinseki’s resignation that the greatest problem with the VA system is ‘too many layers of bureaucrats.’ […] ‘The real issue is that you got to get all that bureaucracy out of there and quite frankly, do we even need that system for most of our veterans? Why can they not be served at the local hospitals where they live and not have to drive 50 or a 100 miles to get a to a veterans facility? These are honored people in our society. They should be welcomed at any of our facilities and we should be honored to take care of them.’” [Daily Caller, 5/30/14]

Ted Cruz
Medicaid
Cruz said, “And one of the things about Medicaid–if you look at the health outcomes on Medicaid, health outcomes are markedly worse when people get on Medicaid. Medicaid is not performing well. And, in fact, people’s life expectancy goes down on Medicaid. It is markedly worse.” Read more in Katie Couric’s interview with Ted Cruz.

Veterans
Cruz said on Veterans’ Day that “if elected president, he would hold the US Department of Veterans Affairs and its employees accountable for “falsely denying care” and “anyone criminally liable will be prosecuted.”   

Cruz specifically criticized Clinton for saying in an interview  that problems at the VA were not “as widespread as it has been made out to be.”

Marco Rubio
Medicaid
Rubio believes we must “move Medicaid into a per-capita cap system, preserving funding for Medicaid’s unique populations, while freeing states from Washington mandates.” Read more on his website.  

Veterans
According to Rubio, “(u)nfortunately today we have a VA that does not do enough for (veterans)” Here’s Everything Feds Need to Know About Thursday’s GOP Debates
Government Executive – Aug 6, 2015 
Rubio said, “(w)e need to have a VA that is more interested in the welfare and security of our veterans than in the job security of federal employees,” Rubio said.Presidential Hopeful Says It Should Be Easier to Fire All Feds
Government Executive – Oct 20, 2015 

I hope you find this and the first part of our series to be helpful! We will continue to keep our readers updated, as the presidential campaign heats up and the candidates continue to refine their positions about these issues. 

Bring Your Mom to Work: On-Site Elder Day Care at Workplaces

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Karen spent many years in school to get her PhD, followed by years of work to become a tenured professor at a university, and eventually a department head. She and her husband delayed starting a family, and when she was in her mid 40’s and at the peak of her career, she had her first child. Every morning, she dropped off her infant daughter, Emily, at the daycare at her university. Things seemed to be working well, until she became a caregiver for her mother, who is in the early stages of dementia.

At first, her mother seemed fine living in Karen’s home, with a paid caregiver coming in to help out intermittently. Then, as time progressed, Karen’s mom’s condition worsened. The day Karen received a scary call about her mother wandering through the neighborhood was when she realized her mother was no longer safe on her own. What should she do? She couldn’t quit her job, and her husband traveled often for his work. She wanted her mother to be able to stay with her for as long as possible. She secretly wished she could bring her mother to work for caregiving as she does her daughter. Soon, maybe she can.

On-Site Daycare, and Bringing Pets to Work . . . Why Not On-Site Elder Day Care?

The average age of caregivers is 49 — a peak year for earnings and for career achievement. As you can see from Karen’s situation in our example, holding a job, being a parent, and caring for a parent at home can be a huge challenge as you attempt to balance competing demands on your time and energy. As our population ages, more families than ever are having to balance this type of care. For more details on this common situation and for tips, please read our recent article on the Sandwich Generation.

Work disruptions due to employee caregiving responsibilities result in productivity losses to businesses at an estimated cost of $33.6 billion per year. So, how are companies responding? Currently, about a third of Fortune’s 100 Best Companies to Work For have on-site child daycare centers. Other companies, such as Google, Ben Jerry’s, Clif Bar, and Amazon, even let you bring your dog to work. But, what about the 24 million Americans — almost half our country’s 40- and 50-year-olds — who are part of the Sandwich Generation that’s simultaneously caring not only their children, but also for an older parent or adult?

Eldercare at Work Idea Addressed at World Economic Forum

Thomas DeRosa, the CEO of Welltower, a $24 billion real estate trust that invests in housing and assisted-living properties for older people, shared the idea of elder care at work at this year’s World Economic Forum annual meeting in Davos, Switzerland, during a panel discussion called “What If You Are Still Alive in 2100?” DeRosa predicted that major corporations could soon allow employees to bring elderly parents or family members to a workplace-based elder daycare system.

The panel discussion where DeRosa’s idea was introduced also addressed topics such as whether the retirement age should be raised, what genetic and sociological factors make a person more likely to live longer, whether governments are prepared for an aging population, whether cities are well-equipped for more older people, and what skill sets older people have that younger people are lacking. However, when it was brought up, DeRosa’s “big idea” really stood out to participants.

He told Business Insider afterwards: “If you think about a business where most the employees are my age (he is in his early 50’s) and think about the people who are faced with: ‘I can’t afford $8,000 a month, my mother has been diagnosed with Alzheimer’s disease and I’m the eldest son or daughter who lives within proximity,’ you have to leave your job. That’s a 24/7 job. Think about the productivity improvement of not losing these skilled employees [by preventing them from having to leave the workplace to become full-time caregivers to their parents.]”

What Your Workplace Can Do (and what are your rights?)

Unfortunately, elder care at work is just a concept at this time, and not a reality yet. However, a growing number of employers recognize caregiving as a workplace issue that affects everyone. Larger corporations sometimes are able to offer support in ways that smaller ones cannot. But there are actions that companies of any size can take to support employees who have caregiving responsibilities:

  • Flexibility in work hours, including a change in hours; a part-time schedule; a compressed work schedule; job sharing; telecommuting and more, could prove to be helpful. Studies show that flexible scheduling improves job performance, decreases tardiness and employee turnover and increases job satisfaction and retention (even for employees are who are not currently caregivers).
  • Companies with 50 or more employees must comply with the federal Family and Medical Leave Act (FMLA), which allows for up to 12 weeks of unpaid leave (or 26 weeks to care for an active service member). The leave may be used to care for a seriously ill parent, spouse or child. Job and health insurance are protected. However, approximately half of U.S. companies have fewer than 50 employees and are exempt from FMLA requirements.
  • Paid Family Leave is a mandated benefit that covers caregivers of a seriously ill parent, child, spouse or registered domestic partner, as well as new parents. Only a handful of states currently require paid family leave.
  • Various state regulations and certain sections of the Americans with Disabilities Act prohibit employers from discriminating against caregiving employees (for example, passing over employees for promotion or stereotyping employees because of caregiving status).
  • Company-sponsored training for supervisors enhances understanding of the conflicting demands of work and caregiving and ensures that mandates for family leave and antidiscrimination regulations are met.
  • Sometimes, larger businesses organize in-house caregiver support groups, informational brown-bag lunch sessions or offer access to outside support groups.
  • Some large companies have in-house social workers or geriatric care managers that are there to help employees.  For example, Iona is a non-profit organization that provides comprehensive support and resources to help employees through the challenges of care-giving. Iona partners with large corporate clients to provide
  • full- or part-time on-site professional consulting by a licensed social worker
    • in-depth customized resources and referrals
    • educational seminars on caregiving and retirement
    • professionally facilitated support groups, and
    • articles for employees on aging/care giving issues
  • Businesses of all size and government agencies frequently host guest speakers, often during a “Lunch and Learn,” on topics relating to Elder Law and Elder Care.  I, for example, have spoken about Estate Planning and Elder Law for caregivers at several “Lunch and Learns” – at Fannie Mae, George Mason University, Mobile/Exxon, and the U.S. Patent and Trademark Office, to name a few.

Take Care of Yourself 

Negotiating time off work, coping with tension-filled family dynamics, and managing your own fears and concerns about your loved one’s well-being all contribute to increased stress and potential burn-out. It’s not selfish to say you need to care for you. Remember to do what you can to stay healthy: eat well, try to get some good sleep and exercise, and seek respite care to give yourself a break. Try to be flexible, accept that you may have to let go of some duties and remember that there will good days and bad days.

When Long-Term Care is Needed

There will most likely come a time when at home (or at work) caregiving is not enough for a loved one. Medicaid planning for a loved one can be started while he or she is still able to make legal and financial decisions, or can be initiated by an adult child acting as agent under a properly-drafted Power of Attorney, even if you are already in a nursing home or receiving other long-term care.  In fact, the majority of our Life Care Planning and Medicaid Asset Protection clients come to us when nursing home care is already in place or is imminent. It is never too late to begin the process of Long-term Care Planning, also called Lifecare Planning and Medicaid Asset Protection Planning.

Planning for long-term care does not eliminate your risk of needing it, but it enables you to sort options and make smarter decisions ahead of time. As a result, you’ll have the peace of mind that no matter what happens, you will know what to do as a family. If you or your loved ones have not done Long-Term Care Planning, please call us as soon as possible to make an appointment for a no-cost initial consultation:

Fairfax Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Rockville Elder Law: 301-519-8041
DC Elder Law: 202-587-2797