Public Benefits Task Force

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.  

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

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

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.

Information on income and resource eligibility for the Medicare Savings Programs (QMB & SLMB) and what those programs cover. 

https://www.ncoa.org/wp-content/uploads/medicare-savings-programs-coverage-and-eligibility.pdf?eType=EmailBlastContent&eId=01c43fc8-0f86-4817-b0c9-ba9070abef70

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.”

From Justice in Aging: