Long-Term Care Program Scrapped by Obama Administration

The Community Living Assistance Services and Supports Act (commonly referred to as the "CLASS" Act) was one of the many controversial components of the 2009 federal health care legislation.  As implemented, the CLASS Act would have allowed any American who paid premiums into a long-term care fund for five years to be then eligible for long-term care benefits of between $50 and $75 per day for various long-term care services, including home care.

Even at those modest numbers -- full-time home care runs about $250 per day in the Hudson Valley, while most local nursing homes average about $350 per day on a private pay basis -- the CLASS Act was deemed financial unsustainable by the Department of Health and Human Services.  The concern was that people most likely to require the services would pay the premiums, while healthier people would opt-out, thereby putting too big a strain on the system.  Apparently concerned that our nation could ill-afford another expensive federal government program, President Obama's administration has decided to halt implementation of the CLASS Act.

To learn more, check out this article at Elder Law Answers.

Class Action Lawsuit Challenges Medicare's "Improvement Standard"

Last fall I posted this entry discussing Medicare's misapplication of a "improvement standard" in determining a whether a person using Medicare days in a nursing home should continue to receive Medicare coverage for the duration of the 100-day maximum Medicare period for each "spell of illness."

On January 18, a number of advocacy groups joined forces and filed a class action lawsuit against the U.S. Department of Health and Human Services alleging that HHS has improperly applied the improvement standard to deny Medicare participants care to which they were entitled.   The lawsuit, Jimmo v. Sebelius, was filed in the United States District Court for the District of Vermont.

A copy of the complaint can be read here.