Category Archives for Healthcare

Medicare slow to fix equity issue for seniors’ access to at-home COVID test kits

Published on Feb. 7 in Rhode Island News Today

Today home test kits were made available in a variety of ways – but, for Medicare recipients, it was a different story, being forced to go thru a different purchasing and payment process than those having private insurance, or no insurance. That process required the oldest and most at-risk population to take more than several steps, put up their own money, do a lot of paperwork, to seek reimbursement.

The White House made changes in testing so that at-home tests are now fully covered by health insurances. Those insured can pick up their test kits in a store and have them paid for at the time of purchase by their insurance, at no cost to the person. They aren’t required to visit their physician or get a prescription to obtain the free test. They have a limit of 8 test kits per month.

But, when the program began, this was not the plan for those insured through the government’s Medicare and Medicare Advantage plans.

Red Tape… Upfront Charges for COVID-1

Jane, a 65-year old Medicare beneficiary from Warwick went through the steps to get a kit after a relative she had seen found out she was exposed to COVID.  Before Medicare announced easing up on the purchasing process of COVID-19 test kits, she expressed frustrations to this writer about the regulatory hoops she faced because she was on Medicare – purchasing the test kits and getting reimbursed for the upfront charges. “First, I had to request a prescription from my physician and say that I had either been exposed to someone who had COVID, or I was having symptoms, myself,” recalls the frustrated Medicare beneficiary.  “Once my physician sent the prescription over to CVS, I was notified that it would take a couple of days before I could pick up the kits and that I would only be given two kits per prescription”, she fumed, knowing that sometimes it takes 4 or 5 days of testing to test positive, but was only eligible to receive two, and she might have to go through the whole process again in a few days.

“Three days later CVS finally left me a message saying these kits were in. I used the drive-up window for pickup and the cashier asked me for $46,” Jane remembered.  “When questioning this charge, a pharmacist came to the window to assist and told me that I had to pay for the kits upfront and then seek reimbursement,” she added.

Paying for the kits, Jane went home, and called Blue Cross, her Medicare supplement company and was told she needed to request a copy of the prescription which took hours to finally request with the back and forth phone calls to her busy doctor’s office. It was almost two weeks later she finally got a copy of the receipt detailing her $46 payment for the kits. She was then able to upload the copy of the prescription and a copy of her receipt to a BCBS reimbursement screen on her computer (or she could have printed the form out and mailed the whole package in). At press time, Jane is still waiting for her reimbursement, being told it will take from 4 to 6 weeks to receive a check.

It’s better late than never, says Jane, when she heard that Medicare would now cover free over-the-counter COVID-19 tests. “Not everyone can put out $46 and wait two months to get it back, home health tests were made available in a variety of ways – but, for Medicare recipients, there was a different process. More concerning was all the steps I had to take to complete the process they had originally intended for us to do. How many people would really complete all those steps?” she says. “We talk a lot about equity, but seniors need equitable healthcare processes, too.”

Just days ago, the Centers for Medicare & Medicaid Services (CMS) announced that beneficiaries in either Original Medicare or Medicare Advantage will be able to get over-the-counter COVID-19 tests at no cost starting in early spring, estimated to be in April. Under the new CMS initiative, Medicare beneficiaries will be able to access up to eight over-the-counter COVID-19 tests per month for free. Tests will be available through eligible pharmacies and other participating entities. This policy will apply to COVID-19 over-the-counter tests approved or authorized by the U.S. Food and Drug Administration (FDA). A prescription will not be required.

CMS Unveils New Medicare Benefit

According to CMS, this new initiative will enable payment from Medicare directly to participating pharmacies and other participating entities to allow Medicare beneficiaries to pick up tests at no cost. This is the first time that Medicare has covered an over-the-counter test at no cost to beneficiaries.

CMS’s announcement follows last month’s announcement that the Biden-Harris Administration would be requiring commercial health insurance companies to cover at-home COVID tests for free.

Until the new benefit kicks in, Medicare beneficiaries can access free tests through a number of channels established by CMS, too. Now, they can request four free over-the-counter tests for home delivery at covidtests.gov. Or beneficiaries can access COVID-19 tests through health care providers at over 20,000 free testing sites nationwide. Many cities and towns are also giving out free test kits at drive-up handout programs as the state receives supplies.

CMS’s Feb. 3 statement noted that Medicare beneficiaries can also access lab-based PCR tests and antigen tests performed by a laboratory when the test is ordered by a physician, non-physician practitioner, pharmacist, or other authorized health care professional at no cost. In addition to accessing a COVID-19 lab test ordered by a health care professional, people with Medicare can also already access one lab-performed test without an order, also without cost sharing, during the public health emergency, says CMS.

In addition, CMS says that Medicare Advantage plans may offer coverage and payment for over-the-counter COVID-19 tests as a supplemental benefit in addition to covering Medicare Part A and Part B benefits. Medicare beneficiaries covered by Medicare Advantage should check with their plan to see if it includes such a benefit.

Finally, all Medicare beneficiaries with Part B are eligible for the new benefit, whether enrolled in a Medicare Advantage plan or not.

“AARP applauds today’s announcement that will guarantee access to at-home over-the-counter COVID-19 tests at no cost for Medicare’s 64 million beneficiaries and we thank [Health and Human Resources]Secretary Becerra and CMS Administrator Brooks-LaSure for their diligence in addressing this issue. Expanded access to no-cost testing will help protect seniors who have been hit hardest by the pandemic and ensure they can remain connected with their loved ones and community.,” says AARP Executive vice president and Chief Advocacy and Engagement Officer Nancy LeaMond in a statement issued with CMS’s Feb. 3rd announcement of the new Medicare benefit.

“Every American should have an easy way to get at-home COVID tests. We know that people 65 and older are at much greater risk of serious illness and death from this disease – they need equal access to tools that can help keep them safe. The cost of paying for tests and the time needed to find free testing options are barriers that could discourage Medicare beneficiaries from getting tested, leading to greater social isolation and continued spread of the virus, adds LeaMond.

Successfully Advocating the Seniors

Last month, Senators Sherrod Brown (D-OH) and Debbie Stabenow (D-MI) along with 17 of their  Senate colleagues including Rhode Island Democratic Senators Reed and Sheldon Whitehouse wrote to HHS Secretary Becerra and  CMS Administrator Brooks-LaSure urging them to expand Medicare coverage of free at-home rapid COVID-19 testing.

Aging groups also joined the Senators in pushing Medicare to offer the new testing kick benefit.  “It is clear that regular testing is a crucial part of managing the spread of COVID-19. That’s why AARP has been calling for coverage of at-home tests, says AARP’s LeaMond, noting that the nation’s largest aging advocacy group “will continue to watch for details about when and how at-home COVID tests are made available to those in Medicare.”

Thankfully CMS quickly heeded their calls.

For more information, please see these Frequently Asked Questions, https://www.cms.gov/files/document/covid-19-over-counter-otc-tests-medicare-frequently-asked-questions.pdf (PDF)

Stay tuned for free N95 masks to be made available to all coming up soon.

Older adults still worried, coping with COVID-19 Delta, poll shows

Published October 11, 2021 in RINewsToday

With the COVID-19 Delta variant numbers having surged across the nation, Joe (70) and Joyce (66), residing across the Rhode Island border in Seekonk, Massachusetts, continue to keep their distance from others, only seeing vaccinated friends and spending time with their daughter and her husband and grandchildren. During the first year of the pandemic, my friends pre-ordered their groceries and picked up the filled bags outside the store, where an employee quickly put the bags in their trunk. Now, this includes a quick 15-minute trip into the store, if necessary. They continue to not eat their meals in restaurants but will pick up their order curbside or eat outside.

Like my longtime friends, many older adults age 50 and over still remained concerned about this virus and continue to isolate themselves from others (especially those unvaccinated) and practice social distancing and wear their masks.

Still Feeling Socially Isolated

According to a newly released survey on Sept. 29, 2021, by the Associated Press-NORC Center for Public Affairs Research and funded by The SCAN Foundation, while a majority of adults age 50 or older see their quality of life, mental health, and satisfaction with social activities and relationships positively, they rarely, or never, feel socially isolated. But still, 18 months into the pandemic,1 in 3 still feel socially isolated at least sometimes. And 1 in 4 feels that their social life and relationships have gotten worse over the past year.

The poll survey includes 1,015 interviews with a nationally representative sample of adults age 50 and older living in America. Interviews were conducted between Aug. 20 and 23, 2021, via internet and phone, in English.

The research findings indicate that those older adults most worried about themselves or a loved one being infected by COVID-19 are most likely to practice social distancing, by avoiding travel, staying away from large groups of people, and wearing a mask. They are the ones most often experiencing feelings of social isolation. The researchers say that these people rate their quality of life, mental and emotional health, and social activities and relationships as worse than those less concerned about the virus.

The study’s findings indicate that being vaccinated does not provide the older persons with relief. Those who are vaccinated are more worried about infection from the virus, are more likely to practice social distancing, and are more likely to describe their mental health as worse than last year compared to those who are not vaccinated.

Touching Others Thru Video Chat and Social Media

To cope with isolation, older adults are using video chat and social media more often since the beginning of the pandemic as the frequency of activities like visiting with friends and family in person, doing volunteer work, attending religious services, and talking with neighbors have declined, the study’s findings indicate. And despite struggles with mental health and isolation, more report that their use of mental health services has declined (34%) than increased (6%).

In addition to the increasing use of technology to socialize, more older adults are using video chat, email, and other technology to receive health care remotely, say the researchers, noting that 63% have used telehealth at some point during the pandemic, up from 56% who had used it as of March 2021. Fifty-1% users expect to continue using it once the pandemic is over, too.

Still, adults age 50 and older are more optimistic than pessimistic that they will be able to fully return to their pre-pandemic activities in the next year, though 17% have already done so.

The results of The Associated Press-NORC Center for Public Affairs Research can be found in “Long-Term Care in America: Coronavirus Worries and Social Isolation among Older Adults,” released on Sept. 2021.

A Call for House Dems to Bring Back House Aging Committee

Published in RINewsToday on August 16, 2021

Just days ago, Congressman David Cicilline, along with fellow lawmakers, Jan Schakowsky (D-IL), Doris Matsui (D-CA), who serve as co-chairs of the House Democratic Caucus Task Force  on Aging and Families, introduced H. Res. 583 to amend the rules of the House to establish a House Permanent Select Committee on Aging. This is the Rhode Island lawmaker’s fourth attempt, and it might well succeed with two co-chairs of the House Caucus Task Force on Aging and Families cosponsoring the resolution.

Getting Schakowsky and Matsui on board is “very significant,” says Cicilline.  He also has the support of the prestigious Washington, D.C.-based Leadership Council on Aging Organizations (LCAO), representing 69 national aging groups.

The original House Permanent Select Committee on Aging, which was active between 1974 and 1992, conducted investigations, hearings and issues reports to inform Congress on issues related to aging, putting a legislative spotlight on the challenges and issues facing the growing aging population in America. 

H. Res. 583 would reestablish the House Aging Committee without having legislative jurisdiction, this being no different than when the permanent committee previously existed. It would be authorized to conduct a continuing comprehensive study and review of aging issues, such as income maintenance, poverty, housing, health (including medical research), welfare, employment, education, recreation, and long-term care. These efforts impacted legislation taken up by standing committees. It has been referred to the House Rules Committee for consideration.

It’s relatively simple to create an ad hoc (temporary) select committee, says the Congressional Research Service. All it takes is a simple resolution that contains language establishing the committee—giving a purpose, defining membership, and detailing other issues that need to be address.  Salaries and expenses of standing committees, special and select, are authorized through the Legislative Branch Appropriations bill.

An Urgent Time Requires Passage of H. Res. 583  

“America’s seniors have spent a lifetime working hard and moving our country forward and they deserve the best in their retirement,” says Cicilline. “The pandemic has disproportionately impacted seniors and now with growing concerns about inflation, seniors on fixed incomes will bear the burden of the rising cost of prescription drugs, food, housing, and other essentials,” he says, noting there has never been a more urgent time for Congress to reauthorize the House Permanent Select Committee on Aging than right now. 

“The pandemic magnified gaps in U.S. policy that routinely forget about Older Americans and the need to nurture a culture that respects them. From the lack of a universal long-term care policy to barriers to vaccine access earlier in the pandemic, these are issues that need to be examined so that Congress can put forward strong solutions to support our aging population and the communities they live in,” says Schakowsky. 

“Older Americans today face many difficulties—including achieving retirement security and affording the rising costs in health care and prescription drugs—which have only been worsened by the COVID-19 pandemic,” said Matsui, stressing by creating a House Aging Committee Congress can continue to strengthen and support policies that are important to seniors throughout the country. 

Supporters Call on House Resolution’s Passage 

As the Leadership Council of Aging Organizations (LCAO), the preeminent national organization representing and focused on the well-being of older adults, noted in its letter of support for reestablished the House Permanent Select Committee on Aging, “now is the opportune time to reestablish the HPSCoA. Every day, 12,000 Americans turn 60. By 2030, nearly 75 million people in the U.S.—or 20% of the country—will be age 65 or older. As America grows older, the need for support and services provided under programs like Social Security, SSI, Medicare, Medicaid and the Older Americans Act also increases.”

“We strongly support Cicilline’s legislation to re-establish the House Permanent Select Committee on Aging. This committee did crucial work on behalf of American seniors between 1974 and 1992, including investigating nursing home abuse, promoting breast cancer screening for older women, improving elderly housing, and bringing attention to elder abuse, among other issues,” says Max Richtman, president and CEO, National Committee to Preserve Social Security and Medicare, warning that “we should not wait another day to re-establish a committee dedicated to protecting America’s seniors.” 

“Cicilline is 100% right that it is time to re-establish this vital committee, with ten thousand Americans turning 65 every day, amid a pandemic that has taken a disproportionate toll on seniors.  Today, there are a new set of issues that demand the attention of a dedicated House committee — prescription drug pricing, long-term care, soaring medical costs and the future of Social Security and Medicare,” adds Richtman.

Bob Blancato who had the longest tenure of any staff on the Committee said: “First I commend Cicilline for introducing the legislation.  The timing was especially good as the release yesterday of the 2020 Census data shows a continued sharp increase in the number of older Americans in our nation.” 

“While I support this legislation it does face considerable odds to gain passage,” warns Blancato, noting that two things could change that.  “The resolution must have backing from House Leadership especially from Speaker Pelosi and it must become bipartisan as the original Committee was.  In the end it is about how do advocates make this into a political issue.  This is an opportunity for the Leadership Council of Aging Organizations to show if it has clout,” he says.

Adds, CEO Sandy Markwood, of National Association of Area Agencies on Aging: “We are a rapidly aging nation: one in five Americans will be age 65 or older within this decade. This historic demographic shift requires policymakers and the public to factor in aging and how we can age well at home and in the community into every policy conversation. For this, the House of Representatives should have a special aging committee as the Senate does: to spotlight not only older Americans, but also the impact of this massive shift on all generations, our communities and society at large. COVID-19 shone a bright spotlight on what we need to do to help older adults age well at home, but local aging leaders like n4a’s members need the House’s leadership to give aging policy the focused attention it deserves…and our demographics demand.”

According to Robert S. Weiner, a close friend and confident of House Aging Committee Chair Claude Pepper (D-Florida) who served as his committee Chief of Staff, the Special Committee was and can  again be the protector of seniors.  “Among its most significant actions — all bipartisan– were advocating and causing enactment of  the law, passed 359-2 in the House and 89-10 in the Senate, barring age based “mandatory retirement and protecting people over 40 from age discrimination,” he remembers.

“The courts are now fudging with that clear intent, and the House Aging Committee would be a visible and influential protector. Transparency by nursing homes and congregate housing settings– as mandated by laws pressed by Pepper decades ago but now ignored —  would be another benefit,” states Weiner. “In housing, health care, nutrition, crime victimization, transportation, accessibility, and social services –in the whole array of actions stopping ageism by local, state, and federal agencies and the courts, including the Supreme Court — the House Aging Committee would again be an invaluable champion for seniors,” he adds. 

“During the 117th Congress, passing H Res. 583 is also necessary to protect against under-the-radar political invasions of Social Security’s surplus — a fund paid by seniors in the program– and attempts to use the money to pay for other programs including tax cuts for the wealthy,” warns Weiner.

As a long-time Washington insider, Weiner says the best way to pass H Res 583 to reestablish the House Aging Committee is for the chief congressional advocate, Cicilline, to talk directly with the top three House leaders, Speaker Nancy Pelosi (D-CA), Majority Leader Steny Hoyer (D-MD and Whip James E. Clyburn (D-SC) and makes the case on the merits and bill’s support while asking for quick endorsement. “Looking back, “that’s how Pepper always did it – he’d pull people to a place on the floor and talk with them there, or on the phone. 

Weiner recalled how Pepper, the fierce aging advocate from Florida, called Rosalyn Carter to ask her husband, President Jimmy Carter for a meeting to discuss the mandatory retirement Carter who ultimately endorsed the bill.  It passed the House 359-2 and the Senate 89-10, being considered by Congress. Ultimately, “the full House Aging Committee (40 members) met with and there was a glorious White House signing ceremony,” he says.

A Call for House Leadership Support 

Cicilline goes into the 117th Congress with the support of long-time Congressional senior advocates, Schakowsky and Matsui and the backing of a prestigious coalition aging organizations to bring back the House Aging Committee.  It will happen this Congress if House Speaker Pelosi along with Majority Leader Hoyer and Whip Clyburn can bring the moderates and progressives of the Democratic House Caucus together to support H. Res. 583.  

Politically it’s the smart thing to do.  It’s a winning policy issue for America’s seniors and this group has traditionally been the highest turnout age group in elections.  But, more important, it’s the right thing to do especially at a time when seniors have been a disproportionately impacted by the continuing COVID-19 pandemic.    

I say pass H. Res. 583.