Public Benefits Task Force

Social Security Adds Five Conditions to the Compassionate Allowance List

Social Security Expands Compassionate Allowance List

Nancy A. Berryhill, Acting Commissioner of Social Security, announced on August 20, 2018 five new Compassionate Allowance conditions: Fibrolamellar Cancer, Megacystis Microcolon Intestinal Hypoperistalsis Syndrome (MMIHS), Megalencephaly Capillary Malformation Syndrome (MCAP), Superficial Siderosis of the Central Nervous System, and Tetrasomy 18p. Compassionate Allowances is a program to quickly identify medical conditions and serious diseases that meet Social Security’s standards for disability benefits.

 The Compassionate Allowances program identifies claims where the applicant’s disease or condition clearly meets Social Security’s statutory standard for disability. Due to the severe nature of many of these conditions, these claims are often allowed based on medical confirmation of the diagnosis alone. The list has grown to a total of 233 conditions, including diseases such as pancreatic cancer, amyotrophic lateral sclerosis (ALS), and acute leukemia.

The agency incorporates leading technology to easily identify potential Compassionate Allowances and make quick decisions. For disability cases not covered by this program, Social Security’s Health IT brings the speed and efficiency of electronic medical records to the disability determination process. When a person applies for disability benefits, Social Security must obtain medical records in order to make an accurate determination. It may take weeks for health care organizations to provide records for the applicant’s case. With electronic records transmission, Social Security is able to quickly obtain a claimant’s medical information, review it, and make a determination faster than ever before.

For more information about the program, including a list of all Compassionate Allowances conditions, please visit https://www.ssa.gov/compassionateallowances/.

To learn more about Social Security’s Health IT program, please visit www.socialsecurity.gov/hit.  

Social Security Regional Office telephone numbers to check on the status of claims

From Matthew Baxter, Social Security Public Affairs Specialist:

It was recently brought to my attention that our field offices occasionally receive calls from representatives, though not necessarily from your firm/organization, concerning the status of their clients’ disability claims and appeals. Please remember that these inquiries should be directed to our regional processing centers.

For disability cases involving clients aged under 53, please consult this chart:

 https://www.ssa.gov/representation/pct_contact_info_under54.htm

 For disability cases involving clients aged 54 and older:

 https://www.ssa.gov/representation/pct_contact_info_54older.htm

Please let me know if you have any questions or whether I can be of any other assistance.

 Best regards,

 Matthew Baxter

Public Affairs Specialist

Social Security Administration

920 West Basin Road, Suite 200

New Castle, DE 19720

 

Phone: 1-877-651-7130 ext. 21570

Fax: 302-323-0845

Email: Matthew.Baxter@ssa.gov

SSI Benefits and Joint Bank Accounts

Dealing with bank accounts of SSI recipients when the funds do not belong to the recipient. 

 

There are several reasons why an SSI recipient may be named on a bank account that belongs to someone else, and generally that bank account should not count as a resource for the SSI recipient. However, problems can occur when ownership of a bank account is not clear to the Social Security Administration (SSA), which can lead SSA to stop SSI benefits due to excess resources.  

The National Center for Law and Elder Rights has some ideas to deal with this problem in their July 2018 practice tip SSI Benefits and Joint Bank Accounts.

SSI Benefits and Joint Bank Accounts

Dealing with bank accounts of SSI recipients when the funds do not belong to the recipient. 

 

There are several reasons why an SSI recipient may be named on a bank account that belongs to someone else, and generally that bank account should not count as a resource for the SSI recipient. However, problems can occur when ownership of a bank account is not clear to the Social Security Administration (SSA), which can lead SSA to stop SSI benefits due to excess resources.  

The National Center for Law and Elder Rights has some ideas to deal with this problem in their July 2018 practice tip. SSI Benefits and Ownership of Joint Bank Accounts

The Office of Administrative Hearings now has a searchable database of selected decisions.

The Office of Administrative Hearings has launched a searchable portal of select decisions dating back to last September to assist attorneys and members of the public with researching administrative law cases. http://decisions-oah.maryland.gov/Pages/Search-Hearings.aspx

SSA expands online wage reporting through mySocial Security to SSI recipients and their rep payees.

I am pleased to announce that we are expanding our my Social Security online wage reporting service to Supplemental Security Income (SSI) recipients, as well as their spouses, parents, sponsors, and representative payees. Individuals receiving both Social Security Disability Insurance (SSDI) and SSI, as well as their representative payees, can also report wages online. This service is available through our existing my Social Security portal. Check our website to learn more about my Social Security features and how to sign up.

Note: SSI recipients, their spouses, parents, sponsors, and representative payees may still use the SSI Mobile Wage Reporting and SSI Telephone Wage Reporting applications. However, the preferred wage reporting method for individuals receiving both SSDI and SSI is the my Social Security online wage reporting service.

Social Security touches the life of nearly every American. By offering more online service options for conducting business with us, we are leveraging technology to better serve the public.

Please share this information through your networks. As always, thank you for your interest in our programs and the public we serve.

Sincerely,

Matthew Baxter
Public Affairs Specialist
(T) 877-651-7130 ext. 21570
@SSAOutreach

 

Maryland Medicaid to cover cochlear implants & hearing aids for adults

From Diasabilty Rights Maryland:

Subject: [NHeLP Confidential] Maryland Medicaid to cover cochlear implants & hearing aids for adults

 I’m thrilled to share that effective July 1, Maryland Medicaid will be covering hearing aids and cochlear implants for adults, which until now were only provided under EPSDT.

 1.       Coverage policy and impact on other states

The CMS-approved SPA includes extensive information about the coverage policy. Hearing aids will be covered as medical equipment, and cochlear implants as prosthetics.

 Disability Rights Maryland (DRM)’s position is that both hearing aids and cochlear implants qualify as “medical equipment” under CMS’s 2016 Home Health Rule (available here; FAQ on the Rule by the National Assistive Technology Advocacy Project is here) and therefore are included in the mandatory home health services benefit. Cochlear implants are classified as prosthetics under Medicare, so it makes some sense that CMS approved them in that category here as well; however, the Home Health Rule also states that if an item could be placed in two categories, including home health, it must still be covered under the home health benefit. This matters because while prosthetics are an optional category, home health is mandatory.

 Because CMS approved coverage of hearing aids as medical equipment, they are subject to the mandatory Home Health Rule that is applicable to all states. In other words, this SPA should help advocates in other states argue for adult coverage of hearing aids as well.

 2.       Proposed regulations

Maryland’s proposed regulations to implement this change are available at http://www.dsd.state.md.us/MDR/4513.pdf (starting at p.671; they amend COMAR 10.09.51, available here). They were issued on June 22 and are subject to a 30-day public comment period through July 23 (which is admittedly after coverage will have already begun). If anyone has thoughts or questions about the regulations, I’d certainly appreciate your input as we’re drafting our comments. Happy to discuss by phone as well.

 3.       HUGE thanks & follow-up discussions

DRM has worked on this project with a team of DC-based Sidley Austin attorneys since 2013. Thanks so much to NHeLP and several others on this list who’ve provided invaluable guidance and brainstorming several times since then.

 If folks have questions about how this came about or would like to discuss our arguments for covering hearing aids and/or cochlear implants under the Home Health Rule, please let me know.

Further information:

Maryland Medicaid provider transmittal: https://mmcp.health.maryland.gov/MCOupdates/Documents/pt_31-18.pdf (noting the Provider Manual online will be updated by 7/1/18)

 Sarah Steege

Attorney
Disability Rights Maryland, formerly Maryland Disability Law Center
1500 Union Ave., Suite 2000
Baltimore, MD 21211

Tel 443-692-2497

Fax 410-727-6389
SarahS@DisabilityRightsMD.org

Visit our new website at www.DisabilityRightsMD.org

 

Maryland Medicaid to cover cochlear implants & hearing aids for adults

From Diasabilty Rights Maryland:

Subject: [NHeLP Confidential] Maryland Medicaid to cover cochlear implants & hearing aids for adults

 I’m thrilled to share that effective July 1, Maryland Medicaid will be covering hearing aids and cochlear implants for adults, which until now were only provided under EPSDT.

 1.       Coverage policy and impact on other states

The CMS-approved SPA includes extensive information about the coverage policy. Hearing aids will be covered as medical equipment, and cochlear implants as prosthetics.

 Disability Rights Maryland (DRM)’s position is that both hearing aids and cochlear implants qualify as “medical equipment” under CMS’s 2016 Home Health Rule (available here; FAQ on the Rule by the National Assistive Technology Advocacy Project is here) and therefore are included in the mandatory home health services benefit. Cochlear implants are classified as prosthetics under Medicare, so it makes some sense that CMS approved them in that category here as well; however, the Home Health Rule also states that if an item could be placed in two categories, including home health, it must still be covered under the home health benefit. This matters because while prosthetics are an optional category, home health is mandatory.

 Because CMS approved coverage of hearing aids as medical equipment, they are subject to the mandatory Home Health Rule that is applicable to all states. In other words, this SPA should help advocates in other states argue for adult coverage of hearing aids as well.

 2.       Proposed regulations

Maryland’s proposed regulations to implement this change are available at http://www.dsd.state.md.us/MDR/4513.pdf (starting at p.671; they amend COMAR 10.09.51, available here). They were issued on June 22 and are subject to a 30-day public comment period through July 23 (which is admittedly after coverage will have already begun). If anyone has thoughts or questions about the regulations, I’d certainly appreciate your input as we’re drafting our comments. Happy to discuss by phone as well.

 3.       HUGE thanks & follow-up discussions

DRM has worked on this project with a team of DC-based Sidley Austin attorneys since 2013. Thanks so much to NHeLP and several others on this list who’ve provided invaluable guidance and brainstorming several times since then.

 If folks have questions about how this came about or would like to discuss our arguments for covering hearing aids and/or cochlear implants under the Home Health Rule, please let me know.

Further information:

Maryland Medicaid provider transmittal: https://mmcp.health.maryland.gov/MCOupdates/Documents/pt_31-18.pdf (noting the Provider Manual online will be updated by 7/1/18)

 Sarah Steege

Attorney
Disability Rights Maryland, formerly Maryland Disability Law Center
1500 Union Ave., Suite 2000
Baltimore, MD 21211

Tel 443-692-2497

Fax 410-727-6389
SarahS@DisabilityRightsMD.org

Visit our new website at www.DisabilityRightsMD.org

 

Maryland Medicaid to cover cochlear implants & hearing aids for adults

From Diasabilty Rights Maryland:

Subject: [NHeLP Confidential] Maryland Medicaid to cover cochlear implants & hearing aids for adults

 I’m thrilled to share that effective July 1, Maryland Medicaid will be covering hearing aids and cochlear implants for adults, which until now were only provided under EPSDT.

 1.       Coverage policy and impact on other states

The CMS-approved SPA includes extensive information about the coverage policy. Hearing aids will be covered as medical equipment, and cochlear implants as prosthetics.

 Disability Rights Maryland (DRM)’s position is that both hearing aids and cochlear implants qualify as “medical equipment” under CMS’s 2016 Home Health Rule (available here; FAQ on the Rule by the National Assistive Technology Advocacy Project is here) and therefore are included in the mandatory home health services benefit. Cochlear implants are classified as prosthetics under Medicare, so it makes some sense that CMS approved them in that category here as well; however, the Home Health Rule also states that if an item could be placed in two categories, including home health, it must still be covered under the home health benefit. This matters because while prosthetics are an optional category, home health is mandatory.

 Because CMS approved coverage of hearing aids as medical equipment, they are subject to the mandatory Home Health Rule that is applicable to all states. In other words, this SPA should help advocates in other states argue for adult coverage of hearing aids as well.

 2.       Proposed regulations

Maryland’s proposed regulations to implement this change are available at http://www.dsd.state.md.us/MDR/4513.pdf (starting at p.671; they amend COMAR 10.09.51, available here). They were issued on June 22 and are subject to a 30-day public comment period through July 23 (which is admittedly after coverage will have already begun). If anyone has thoughts or questions about the regulations, I’d certainly appreciate your input as we’re drafting our comments. Happy to discuss by phone as well.

 3.       HUGE thanks & follow-up discussions

DRM has worked on this project with a team of DC-based Sidley Austin attorneys since 2013. Thanks so much to NHeLP and several others on this list who’ve provided invaluable guidance and brainstorming several times since then.

 If folks have questions about how this came about or would like to discuss our arguments for covering hearing aids and/or cochlear implants under the Home Health Rule, please let me know.

Further information:

Maryland Medicaid provider transmittal: https://mmcp.health.maryland.gov/MCOupdates/Documents/pt_31-18.pdf (noting the Provider Manual online will be updated by 7/1/18)

 Sarah Steege

Attorney
Disability Rights Maryland, formerly Maryland Disability Law Center
1500 Union Ave., Suite 2000
Baltimore, MD 21211

Tel 443-692-2497

Fax 410-727-6389
SarahS@DisabilityRightsMD.org

Visit our new website at www.DisabilityRightsMD.org

 

Updated chart for special enrollment periods under the ACA

The Center on Budget and Policy Priorities has published an updated chart on the events that trigger a special enrollment period under the Affordable Care Act. Normally one can only enroll in a health plan through the exchange during a now limited open enrollment period. However certain events can permit one to enroll at any time. The chart sets out information about these "special enrollment periods."

http://www.healthreformbeyondthebasics.org/wp-content/uploads/2015/06/SEP-Reference-Chart.pdf

Trustees Report on the Social Security Trust Funds

On June 5, 2018 the Social Security Board of Trustees released its annual report on the long-term financial status of the Social Security Trust Funds. Social Security is NOT going bankrupt.

The OASI Trust Fund (retirement and survivors’ benefits) is projected to become depleted in late 2034, as compared to last year’s estimate of early 2035, with 77 percent of benefits payable at that time. The DI Trust Fund (disability benefits) will become depleted in 2032, extended from last year’s estimate of 2028, with 96 percent of benefits still payable.

With no action from Congress, Social Security can continue to provide 100% of the retirement benefits people are owed until 2034. After that, even if absolutely no changes were made, beneficiaries would still receive 77% of their benefits. People receiving disability benefits will get their full benefit check until 2032 and, if Congress makes no changes, they will receive 96% of their benefits thereafter.

You can read the entire report by clicking here.

The Baltimore Social Security office at the Rotunda will close June 22, 2018.

Social Security is closing many local offices nationwide, perhaps as many as 125 since 2000. This makes it more difficult for the elderly and people with disablities to access services and get information.

Read more at: http://www.baltimoresun.com/news/maryland/baltimore-city/bs-md-ci-social-security-office-closing-20180516-story.html

How Medicaid Work Requirements Will Harm Older Adults & Family Caregivers

Justice in Aging explains how work requirements and onerous reporting obligations create barriers to health care access for many older adults, people with disabilities and serious health conditions, and family caregivers who rely on Medicaid.  http://www.justiceinaging.org/wp-content/uploads/2018/04/How-Medicaid-Work-Requirements-Will-Harm-Older-Adults-Family-Caregivers.pdf?eType=EmailBlastContent&eId=1dd68041-dfb6-4dc3-9bf5-48b7d85d7599

A new law will bring added oversight to Social Security's representative payee program. (From Disability Scoop)

Trump Signs Bill Adding Protections For Social Security, SSI Recipients

by Shaun Heasley | April 17, 2018

Individuals tasked with handling Social Security payments for people with disabilities will be subject to greater scrutiny under a new law signed by President Donald Trump.

The president signed the measure known as the Strengthening Protections for Social Security Beneficiaries Act of 2018, or H.R. 4547, late last week after it was unanimously approved by Congress.

The legislation will impose greater oversight on representative payees who manage Social Security and Supplemental Security Income benefits for those who need assistance.

Specifically, the law bars people with certain types of criminal convictions from acting as representative payees and prevents individuals who have representative payees themselves from serving in that capacity for others. And, it will give beneficiaries more say in who handles money on their behalf by allowing Social Security recipients to make a list of their preferred payees in order of preference.

Meanwhile, the legislation will require that protection and advocacy groups in each state — federally-mandated organizations that provide legal assistance and advocate for people with disabilities — conduct more reviews of representative payee performance on behalf of the Social Security Administration.

In addition to enhancing oversight, the measure will also eliminate a requirement that parents or spouses living with a person with a disability complete an annual accounting form for representative payees.

“This new law is great news for the millions of Social Security beneficiaries who rely on a representative payee to help them manage their benefits,” said U.S. Rep. Sam Johnson, R-Texas, who sponsored the legislation. “Not only will it provide much-needed accountability for the representative payee program, but it also puts measures into place that ensure newly selected representative payees are qualified and trustworthy.”

According to the Social Security Administration’s Office of the Inspector General, some 6.2 million individuals or organizations act as representative payees on behalf of about 8 million beneficiaries. Such representatives are assigned if the agency determines that a person’s mental or physical condition prevents them from being able to manage their benefits.

Proponents of the legislation cited concerns from the Government Accountability Office, the Social Security Administration’s Office of the Inspector General, the National Academy of Sciences and the Social Security Advisory Board about how Social Security officials have administered the representative payee program.

“For too long dishonest representative payees have exploited and abused people with disabilities without fear of being discovered,” said Curt Decker, executive director of the National Disability Rights Network, an umbrella group for the nation’s protection and advocacy organizations. “That stops today. We are thrilled to see that Congress has acted to protect the more than 8 million Americans who currently have representative payees.”

Elder Law articles

The MSBA Bar Bulletin, April 15, 2018, has a lot of good substantive articles on elder law topics - Adv Directives and MOLST, Guardianship changes, Social Security Disability changes, ABLE, new Medicare cards and MA-LTC rules about protecting the home under the Parental Care Rule.

New Budget Increases Some Programs for the Elderly

From Justice in Aging:

FY 2018 Omnibus Spending Bill Includes Increased Funding for Older Adult Programs

The FY 2018 omnibus spending bill (H.R. 1625), signed Friday by President Trump, included significant increases for vital Older Americans Act programs, as well as continued funding to support the administrative aspects of the Social Security Administration and the Center for Medicare & Medicaid Services.

The bill included:

  • Social Security: A proposed budget increase of $388 million for the Social Security administrative fund. $280 million is set aside specifically for modernizing the agency’s IT infrastructure, and $100 million for reducing the backlog of appeal hearings.  
  • Housing: $678 million for the Section 202 program that provides assistance to older adults, including $105 million for new Section 202 construction and project-based rental assistance. It expands rental assistance for Section 202 Housing for the Elderly communities, provides funding for new construction for housing for people with disabilities, and increases funding for Housing Choice Vouchers, public housing, and homeless assistance, among other programs. 
  • Health: $49 million in funding for State Health Insurance Assistance Programs (SHIPs) for FY18, which is a $2 million increase from FY17, but still $3 million less than FY 2016.
  • Energy Assistance: $250 million increase for the Low-Income Home Energy Assistance Program (LIHEAP), for a total of $3.6 billion.
  • Nutrition: Supplemental Nutrition Assistance Program (SNAP) funding at $74 billion, a $4.5 billion cut (nearly 6%) from FY 2017. The bill also allows for work requirements.
  • Community Services: Level funding for the Community Services Block Grant at $715 million, and the Social Services Block Grant at $1.7 billion. The Community Development Block Grant received a $300 million (10 percent) boost to $3.3 billion.
  • Legal Services and Elder Justice: $410 million for the Legal Services Corporation (LSC), a $25 million overall increase from FY 2017 levels. The Older Americans Act, Title IIIB Supportive Services received a 10% increase, for a funding level of $385 million. Adult Protective Services (APS) and the Elder Justice Initiative received increased funding of $12 million, a $2 million increase.


The package that passed did not include other health care bills that we were watching, such as the EMPOWER Care Act (S.2227, H.R. 5306), which would extend the Medicaid Money Follows the Person Program, and the BENES Act (S.1909, H.R.2575), which would simplify and improve the Medicare Part B enrollment process.

Contact Us

Justice in Aging
(202) 289-6976
info@justiceinaging.org
View as webpage

New Budget Increases Some Programs for the Elderly

From Justice in Aging:

FY 2018 Omnibus Spending Bill Includes Increased Funding for Older Adult Programs

The FY 2018 omnibus spending bill (H.R. 1625), signed Friday by President Trump, included significant increases for vital Older Americans Act programs, as well as continued funding to support the administrative aspects of the Social Security Administration and the Center for Medicare & Medicaid Services.

The bill included:

  • Social Security: A proposed budget increase of $388 million for the Social Security administrative fund. $280 million is set aside specifically for modernizing the agency’s IT infrastructure, and $100 million for reducing the backlog of appeal hearings.  
  • Housing: $678 million for the Section 202 program that provides assistance to older adults, including $105 million for new Section 202 construction and project-based rental assistance. It expands rental assistance for Section 202 Housing for the Elderly communities, provides funding for new construction for housing for people with disabilities, and increases funding for Housing Choice Vouchers, public housing, and homeless assistance, among other programs. 
  • Health: $49 million in funding for State Health Insurance Assistance Programs (SHIPs) for FY18, which is a $2 million increase from FY17, but still $3 million less than FY 2016.
  • Energy Assistance: $250 million increase for the Low-Income Home Energy Assistance Program (LIHEAP), for a total of $3.6 billion.
  • Nutrition: Supplemental Nutrition Assistance Program (SNAP) funding at $74 billion, a $4.5 billion cut (nearly 6%) from FY 2017. The bill also allows for work requirements.
  • Community Services: Level funding for the Community Services Block Grant at $715 million, and the Social Services Block Grant at $1.7 billion. The Community Development Block Grant received a $300 million (10 percent) boost to $3.3 billion.
  • Legal Services and Elder Justice: $410 million for the Legal Services Corporation (LSC), a $25 million overall increase from FY 2017 levels. The Older Americans Act, Title IIIB Supportive Services received a 10% increase, for a funding level of $385 million. Adult Protective Services (APS) and the Elder Justice Initiative received increased funding of $12 million, a $2 million increase.


The package that passed did not include other health care bills that we were watching, such as the EMPOWER Care Act (S.2227, H.R. 5306), which would extend the Medicaid Money Follows the Person Program, and the BENES Act (S.1909, H.R.2575), which would simplify and improve the Medicare Part B enrollment process.

Contact Us

Justice in Aging
(202) 289-6976
info@justiceinaging.org
View as webpage

SSA's Data on Hearing Delays at Office of Hearings Operations (formerly ODAR) Locations

The Soc. Sec. Admin. releases data the average time (in months) from the date of the hearing request until a hearing was held for cases closed in the Office of Hearings Operations' hearing offices or national hearing centers.

Baltimore City   17 months

Natiional Hearing Cntr, Balt.  17.5 months

Dover, DE  17 months

Morgantown, WV  21 months

Washington 20 months

https://www.ssa.gov/appeals/DataSets/01_NetStat_Report.html

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