News

  • Legislative Update Week Ending January 11 2019

    Critics of mandatory arbitration say the agreements stack the deck against long term care residents and consumers. Unlike civil suits which go to court, arbitration is private, and there's no judge or jury. There are no rules of evidence that arbitrators have to follow under the law, and there's no oversight. Critics also contend that consumers are less likely to win their cases in private arbitration and, if they do win, they tend to get much less money than they would in court. .The extra time was needed because although both houses of Congress were finally able to pass the needed legislation, the bill was nearly 5,600 pages in length. It is probable that no member of Congress actually read the entire bill and likely very few Congressional staff members read it either. .TSCL enthusiastically supports H.R. 1030, H.R. 3118, and H.R. 1795, and we were pleased to see support grow for them this week. … Continued

  • Category Congressional Corner Page 4

    House members are increasingly feeling the effects of a five percent budget cut passed last year. Already tight budgets have forced drastic reductions in the number of salaried positions and could reduce the amount of services provided. .First, two new cosponsors – Senator Chris Van Hollen (MD) and Senator Deb Fischer (NE) – signed on to the bipartisan Know the Lowest Price Act (S. 2553), bringing the total up to thirteen. If adopted, the bill would prohibit "gag clauses" that prevent pharmacists from telling patients when their prescriptions would be cheaper out-of-pocket than through their insurance plans. .Medicare health plans also have new rules about co-pays and co-insurance. Copayments can vary drastically between MA plans, but through 2018, individual plans were required to offer all enrollees in the plan's service area access to the same benefits at the same level of cost - sharing. In 2019, MA plans have the option of imposing tiers for the cost - sharing of contracted providers, as an incentive to encourage enrollees to seek care from specific providers. Plans that utilize tiered cost-sharing must disclose tiered co-pays and co-insurance amounts to enrollees and providers, ensure that services at each tier of cost-sharing are available to all enrollees, and ensure that all enrollees are charged the same amount for the same service from the same provider. … Continued

Second, three new cosponsors signed on to the Social Security Expansion Act (H.R. 1114), bringing the total up to thirty-six. The new cosponsors are Representative Robert Brady (PA-1), Representative Albio Sires (NJ-8), and Representative Tim Ryan (OH-13). If adopted, H.R. 1114 would enhance Social Security benefits by basing COLAs on the CPI-E, increasing monthly benefits by around , improving the Special Minimum Benefit, applying the payroll tax to income above 0,000, and applying a 6.2 percent tax on investment income for wealthy individuals. .Under the rule he's considering formally proposing, Trump would order reimbursement for certain Part B drugs to be tied to what's known as the International Price Index. That would mean a price cut for many medicines, since the prices drug makers charge outside the U.S. are often set by government-run health-care systems and are generally lower. Medicare doesn't use its position as a big buyer of drugs to bargain for lower prices. .The fact is no one can know ahead of time what healthcare will be needed in the future, let alone the actual costs of the services that providers charge. Doctors frequently refer patients to expensive specialists, and order endless expensive tests without spending adequate time to explain why the tests are necessary, how much they cost, or the chances of improving treatments through their use. .A person with average Social Security benefits in 2000 received 6 per month, a figure that rose to ,166.30 by 201However, that individual would require a Social Security benefit of ,419.00 per month in 2015 just to maintain his or her 2000 buying power, the study found. .Compare plans! Use health and drug plan comparison tools found at www.Medicare.gov — Because premiums, out-of-pocket costs and drug coverage vary so enormously between plans, the single best habit to get into is comparing your coverage options every year. Your best tools for comparing health and drug plans coverage and information about premiums and costs can be found online at http://www.Medicare.gov. If you don't have computer or Internet access, work with a friend or family member who does. Or you can get one-on-one counseling assistance through your state health insurance assistance program (SHIP). Many of these programs operate through local area agencies on aging. .This week, Members of Congress remained in their home states and districts to continue the seven-week summer recess. They are expected to return to Capitol Hill on Tuesday, September 6th. In the meantime, most Members of Congress will be holding town hall meetings in their home states and districts. TSCL encourages its members and supporters to attend these events and to voice their concerns about important Social Security and Medicare issues. .Although no other generation has yet been affected by a similar Notch, that could change in the future. Congressional inaction on Social Security's long-term financing problems could give birth to a whole new generation of Notch Babies. During recent hearings on the need for making Social Security more sustainable as Baby Boomers near retirement, David Walker, the Comptroller General of the United States, confirmed this saying "Doing nothing means that we are going to head to a precipitous decline in benefits. Remember the Notch Baby problem?" he asked. "This would be a Notch Baby problem magnified multiple times and it should not be allowed to happen." (10) .After the drug executives announced they would not meet with the President, he went on Twitter and accused the pharmaceutical industry of running ads that lied about his new executive order. .TSCL is very disappointed to hear President Trump continue to demand a payroll tax cut before he will agree to any new legislation dealing with the effects of the pandemic emergency.