The U.S. Equal Employment Opportunity Commission (EEOC) has won one of its first disability discrimination lawsuits concerning bipolar disorder. Cottonwood Financial, which does business as The Cash Store, violated the Americans with Disabilities Act (ADA) and the Washington Law Against Discrimination (WLAD) when it fired an employee with bipolar disorder. The employee’s request for sick leave to adjust to new medication was denied and he was fired days later. The ADA and the WLAD prohibit employment decisions based on an employee’s real or perceived disability or request for an accommodation.

Mobility Map is a Web-based tool that helps consumers find wheelchairs and other mobility equipment. The Mobility Map provides people with disabilities guidance in getting wheelchairs and other mobility equipment that meets their specific needs. It also offers tips on identifying your “wheelchair team” such as physicians and medical equipment suppliers, how to obtain a wheelchair evaluation, and where to find funding.

Report from the National Alliance for Caregiving that describes the impact of caregiving on individuals who care for a friend or family member living with Multiple Sclerosis. Key findings include: caregivers spend an average of 24 hours a week providing care; 22 percent have lost jobs due to caregiving; and there are negative affects relating to their finances, their mental health, and their ability to participate in hobbies or outside activities. This link opens a PDF document.

The Centers for Disease Control and Prevention (CDC) has released a report that shows that about one in 88 children in the United States has autism or a related disorder. This is an overall increase of about 23 percent since a report in 2009. The report also shows that Autism spectrum disorders are almost five times more common among boys than girls.

Fact sheet highlighting the latest emergency preparedness information available from the Ready Campaign for older Americans and people with disabilities. Ready is a national public service advertising (PSA) campaign produced by The Advertising Council for Federal Emergency Management Agency (FEMA) to educate and empower Americans to prepare for and respond to emergencies including natural disasters and potential terrorist attacks. This link opens a PDF document.

Two years ago in March, President Barack Obama signed into law a historic piece of health care reform, the Affordable Care Act of 2010 (ACA). Since then, despite the heated political debates, much action and transformation in the health care arena has taken place, especially in California.

Some of the statewide changes include setting up a health care “Exchange” to provide low-cost health insurance to millions more people by 2014. Policymakers are currently choosing the “essential” benefits to be covered in these plans. Another change is setting up Accountable Care Organizations (ACOs) to help doctors, hospitals, and other health care providers better coordinate care for Medicare patients across various health care settings. The idea is to reduce costs and increase wellness. ACOs that lower their growth in costs while meeting performance standards on quality of care and putting patients first will be rewarded through Medicare’s Shared Savings Program.

The state is also preparing to shift 1.2 million beneficiaries with Medi-Cal fee-for-service coverage into Medi-Cal managed care. This process has met some significant challenges in ensuring/guaranteeing that beneficiaries experience a seamless transition in their access to providers, treatment and medication, and hence may be delayed or slowed.

Some other health care reform induced changes in California that are highlighted in a recent report by Health Access (PDF) include:

• About 8,600 Californians with pre-existing medical conditions have gained access to affordable health insurance. Patients who have illnesses such as cancer or multiple sclerosis – who face high costs or denials on the open market – can buy insurance through the program.
• More than 350,000 young adults have been able to stay on their parents’ health insurance plans until they are 26.
• More than 370,000 low-income people have been covered by an expansion of Medi-Cal, the health insurer for low-income Californians, that is part of the state’s “bridge to reform” waiver to alter the state-federal program.

And, in addition, Medicare beneficiaries across the state and the country are experiencing numerous specific benefits from health reform, including:

• Many new and continued Medicare preventive benefits, mostly at no cost. Some of these include: an annual wellness visit, cancer screenings, smoking cessation counseling, and obesity screening and counseling.
• Lower out-of-pocket Part D prescription drug costs for people with large medication expenses. Beneficiaries who reach the coverage gap (also known as the donut hole) now only pay 50% of their brand name drug costs and 86% of their generic costs versus 100%. This amount will decrease gradually until 2020 when beneficiaries will just pay 25% of their drug costs. The gradual closing of the coverage gap has resulted in over $171 million of savings to beneficiaries, according Health Access’ recent report (PDF).
• An end to wasteful overpayments to Medicare Advantage (MA) plans, saving both taxpayers and the Medicare program millions of dollars. By 2014, MA plans will be required to invest at least 85% of all the funds they collect in premiums and copayments back into quality health care services for beneficiaries versus high administrative costs and profits.

Currently, the health care reform law is only partially implemented. If and when it is allowed to be fully implemented, virtually all Americans will have access to affordable health care coverage. Also, our health care system will run more efficiently and effectively, ensuring quality of care for all residents and reversing the trend of skyrocketing health care costs. Health care reform benefits all, beneficiaries, families, young adults, children and our communities. Let’s keep it going!

The California Antipsychotic Drug Collaborative recently investigated 24 nursing homes and found 147 violations of state rules regarding the use of antipsychotics on residents. Their investigations confirm the disturbing and rampant misuse of antipsychotics in California nursing homes and call attention to a situation that deserves immediate remedial action.

Heart disease is the number one cause of death here in the U.S., with 1 in 3 Americans developing the disease in their lifetime and over 2 million Americans suffering from a heart attack or stroke each year. While some people’s first “wake-up call” on their heart health ranges from a mild or fatal heart attack, most people’s heart health begins deteriorating years before such an event. The most common attributing factors to heart disease are a diet high in fat and sugar and low in nutrients, smoking, lack of exercise, obesity and stress. Some or all of these factors overtime clog and harden people’s arteries, increase people’s cholesterol, cause weight gain and generally wear people’s health – their bodies, minds and spirits – down.

Heart disease costs our country over $444 billion per year in health care costs and loss of economic productivity. It also amounts to 2,200 deaths per day, or 815,000 American lives each year. In addition to the fatalities, heart disease can also result in serious illness, disability, and decreased quality of life. Suffering a stroke may lead to significant disability, such as paralysis, speech difficulties, and emotional problems. Following a heart attack, many people experience fatigue and depression, and find it more difficult to engage in physical activities. Heart disease and stroke are among the leading causes of disability in the United States, with more than 3 million people reporting disability from these causes.

For all the deaths, disability, decreased quality of life and high costs attributed to heart disease, last fall the federal government formed a collaborative partnership and launched a national initiative with communities, health systems, nonprofit organizations, federal agencies, and private-sector partners from across the country to fight heart disease and stroke. The initiative, called Million Hearts™ aims to prevent 1 million heart attacks and strokes over five years.

The Centers for Medicare and Medicaid Services (CMS) plays a major role in promoting this campaign and also educates Medicare beneficiaries on some of Medicare’s new and existing preventive benefits that aim to reduce hearth disease. These include:

• Cardiovascular disease behavioral therapy
• Cardiovascular screenings
• Medical nutrition therapy
• Obesity screening and counseling
• Smoking cessation

See Medicare Preventive benefits for a full list of all covered preventive services.

Prevention is one of the best medicines for individual, community and national health. While following the ABCS (appropriate aspirin therapy, blood pressure control, cholesterol management, and smoking cessation) promoted in the Million Hearts™ initiative are helpful guidelines for heart disease prevention, some medical professionals offer more radical, yet natural approaches to reverse heart disease without drugs. Dr. Joel Fuhrman, author of Eat to Live,  discusses the science, safety and effectiveness of eating a radically nutrient dense diet for reversing heart disease, diabetes and obesity. It’s a simple, natural, drug-free and low-cost approach to reversing disease and enjoying life-long health and vitality. Read the article, Heart Disease: reversing heart disease without surgery and more effectively than with drugs, for more information.

Last week an 82 year old grandmother caught her doctor committing fraud. With a hidden camera, Doris Ace of Texas, filmed her doctor’s visit where she clearly articulates that she is healthy and active. Despite some hypertension and arthritis, she is in good health and feeling great.

Yet, contrary to her relatively clean bill of health, she was diagnosed as homebound, having a whole host of ailments that she does not have, including Type 2 diabetes. Such diagnosis opens the door for her providers to potentially bill Medicare for tens of thousands of dollars in home health care services, supplies and equipment she does not need.

While federal authorities in Texas are currently investigating this case, Ms. Ace demonstrates the radical and important role each beneficiary can play in protecting their Medicare benefits and the integrity of the Medicare program.

Read ABC’s news article for more info on this case. See our Medicare Fraud section for more information on how to prevent, detect and report fraud, and also how to become a volunteer with your local Senior Medicare Patrol (SMP) project. California’s SMP has over 450 volunteers statewide.

We recently received an alert from the Federal Trade Commission (FTC) regarding the  telemarketing of medical alert services. Marketers making unsolicited phone calls are attempting to pressure elderly consumers into buying medical alert services. The services supposedly allow consumers to receive help during emergencies by pushing a button on a pendant.

Although many consumers reporting this scam have refused te buy the services, they continue to receive numerous letters in the mail demanding payment for the unwanted services. Typically, the letters contain phony invoices and threaten consumers with legal action if they do not immediately pay the false charges. Consumers have also received abusive follow-up phone calls from marketers and have even received packages in the mail containing unordered medical alert pendants.

If you hear of or receive any such calls, please report them to our California Senior Medicare Patrol (SMP) project at 1-855-613-7080. We will forward on all reports to the Federal Trade Commission, which is the federal governmenfs consumer protection agency that brings federal court law enforcement actions to stop fraud and obtain refunds for consumers.

As of January 1st of this year, all beneficiaries who are denied coverage for a drug are entitled to receive a standardized written notice from the pharmacy explaining their Part D appeal rights.  This change is due to the Affordable Care Act (ACA). Prior to this year, pharmacies could either hand out this information or just post a notice in the pharmacy without specifically alerting an affected beneficiary to their appeal rights. In addition, prior to this year none of these appeals rights forms were standardized. The new rule from the ACA requires pharmacies to use a new standardized form, Medicare Prescription Drug Coverage and Your Rights (instructions and form can be downloaded here). A Spanish version will also be posted soon.

This requirement and standardized form is an important change for beneficiaries in terms of them being aware of and accessing their Part D appeal rights. Currently, the way the Part D appeals system is set up, the appeals process is NOT triggered when a beneficiary cannot obtain their drugs at a pharmacy. Nothing will happen unless the beneficiary proactively takes action and requests a “coverage determination” or “exception.” Only once an adverse coverage determination is initiated will the appeals process begin. (See our Part D appeals section for more info). Therefore, making sure each beneficiary who cannot get his/her drugs knows about their rights and HOW to start the appeals process is imperative to them having full access to their entitled benefits.

Questions regarding this new standardized notice can be sent to PartD_Appeals@cms.hhs.gov.

Additional information including frequently asked questions are included in the Centers for Medicare and Medicaid Services (CMS) memorandum sent out to all Part D sponsors entitled Revised Standardized Pharmacy Notice (CMS Form – 10147) (PDF).

Have you seen the documentary film, The Good News in American Medicine? You may think that statement is a contradiction in itself, BUT this 52 minute film interviews groups of innovative doctors and clinics around the country that are successfully demonstrating effective ways to provide quality health care to all their local residents at a fraction of the cost of neighboring communities. This film exposes the strategies, generosity, leadership and out-of-the box thinking used by these various communities across the nation.

Washington Post

On health-care hearing’s last day, court weighs severability, Medicaid expansion [SCOTUS, health-care law] — N.C. Aizenman and Robert Barnes report on the third and final day of arguments about the health-care law in front of the Supreme Court; today’s topic: will the entire law fall apart if just aspects of it are found unconstitutional?

U.S. Interior Dept. taking comment on plan to allow seismic testing for oil, gas in Atlantic [Interior Department, energy] — AP reports that the Interior Department is seeking comments from the public on the plan to allow energy companies to begin seismic testing in order to find oil and natural reserves in the Atlantic Ocean

President Obama defends ‘flexibility’ remarks to Medvedev [President Obama] — David Nakamura reports that President Obama is defending his unknowingly recorded comment on “flexibility” to Russian President Dmitry Medvedev on European missile defense, saying that a consensus at a critical time in the American presidential race (and in the wake of Russian presidential elections) would be difficult

Federal health benefits win for gay couple is limited [FEHBP, federal employees] — Joe Davidson reports that while a federal lawyer’s same-sex partner has been granted insurance coverage by the Federal Employees Health Benefits Program — as married couples do — it’s clear that this case is currently the exception, not the rule

Lawmakers challenge limit on Defense employment [Defense Department, federal employees] — Eric Yoder reports that a group of lawmakers is speaking out on the initiative to limit employment at the Defense Department — the government’s largest employer — because they believe it threatens to raise costs and allow contractors to take over work traditionally performed by federal employees

New York Times

U.S. and Pakistan take step to mend relations [Pakistan, foreign relations] — Salman Masood and Declan Walsh report that while a meeting between President Obama and Pakistani Prime Minister Yousaf Raza Gilani is a hopeful step, the relationship remains strained

Judges rule against pilot in privacy case [FAA, privacy, public health] — John H. Cushman Jr. reports that the Supreme Court ruled against the private pilot who had his secret H.I.V.-positive status shared improperly between government agencies; the pilot sought to collect damages for the emotional distress he suffered after being punished by the Federal Aviation Administration for hiding his medical condition

Final approval by House sends jobs bill to President for signature [Jobs bill] — Jonathan Weisman reports that the House has approved a package of measures intended to ease access to capital and investments for entrepreneurs, and it’s been sent to the White House for signing

Wall Street Journal

Treasury to cut costs by remaking coins, replacing paper [Treasury] — Eric Morath reports on the cost-saving measures that Treasury Secretary Tim Geithner has announced for his agency, including changing the materials that go into making coins, replacing paper with electronic communications, and consolidating internal agencies

Fed prevented ‘total meltdown,’ Bernanke says [Federal Reserve] — Kristina Peterson and Michael R. Crittenden report on Federal Reserve Chairman Ben Bernanke’s latest defense of the Fed’s repsonse to the 2008 financial crisis, saying that the Fed prevented a “total meltdown” of the financial system

Two elder women share their stories via Youtube about a 90% rate increase for their long-term care (LTC) insurance policy premiums with John Hancock Financial. They are demanding that Congress put a cap on the amount that premiums can be raised for policyholders over a certain age. Both women are retired and on limited incomes. They both bought a LTC policy well over a decade ago to protect their assets and ensure that they don’t have to rely on the goverment to pay for their LTC costs.

The Department of Health and Human Services estimates that about 70% of American’s will require some form of this kind of care during their lifetime, either in their own home or community, in an assisted living facility or in a nursing home. The cost of these services is very high, ranging from $4,000 – $8,000 a month. About 7 million American’s have purchased long-term care insurance to help cover these expenses.

Patricia Rief-Heskett, one of the women in the video, says that she might have expected a 5% or 10% increase, but not one that nearly doubles her monthly premium from $200 to $370. The letters she and her friend Sylvia (the other woman in the video) received from John Hancock also state that another rate increase could happen again next year.

Patricia says she feels she is at the mercy of this large multi-billion dollar company, which she says took in over $8.6 billion dollars in premiums last quarter. She thinks John Hancock Financial must know that most of their policyholders are older, retired adults, and won’t be able to pay the increase. Many may be forced to drop their policies before ever using any of their benefits, says Patricia. She says this could be a big “win” for the company but is criminal for those who have invested their hard-earned money into their policy.

Bonnie Burns, our Training and Policy Specialist and long-time advocate for ensuring long-term care insurance rights for consumers, reminds policyholders that they have certain rights in California following a premium increase. They may be able to stop paying premiums and keep benefits equal to the premiums they have already paid, or reduce certain benefits in their policy in return for a lower premium. Policyholders in other states may have similar rights. Consumers can contact their state insurance counseling program (HICAP in California) or their state insurance department for assistance.

People considering long-term care policies and other options for financing their long-term care are encouraged to view the information and resources in our Long-Term Care section. For questions and/or counseling on your LTC options, contact your local Health Insurance Counseling and Advocacy Program (HICAP).

Also, watch the full 7-minute youtube video of Patricia and Sylvia, representing the voices of millions of elders, demanding that Congress cap the amount of premium that can be charged to people with LTC insurance who are over a certain age at the time of a premium increase.

U.S. Attorney General Eric Holder has signed a final rule extending the date for compliance with sections 242 and 1009 of the 2010 Americans with Disabilities Act Standards for Accessible Design. The rule requires accessible access to existing swimming pools, wading pools, and spas for a period of 60 days after the publication of the rule in the Federal Register. Another Notice of Proposed Rulemaking (NPRM) was also issued for public comment on extending period to 180 days to allow pool owners and operators to meet compliance obligations. Comments on the NPRM must be submitted on or before April 4, 2012.