LTC Bullet: LTC Embed Report from the Policy Front in Pennsylvania

Tuesday, July 13, 2010

Harrisburg, PA--

LTC Comment: We preview our week of research in Harrisburg, PA after the ***news.***

*** CLASS CONFUSION. In "LTC E-Alert: New CLASS Fix Draft" on Tuesday, July 6, 2010, we reported thus: The effective date of CLASS is January 1, 2011, but the Secretary’s final plan isn't due until October 1, 2012. Nevertheless, stakeholders worry about HHS collecting revenues through CLASS before the 2012 plan. Why? Because, the Medicare Actuary's April 22 report shows $2.8 billion and $4.5 billion in CLASS revenues for 2011 and 2012, respectively. If CLASS won't get underway earlier than late 2012, and more likely 2013, where's all that revenue coming from? We have an answer from a CMS official who will remain anonymous: "Our 4/22 estimate assumed that the program would be effective and participants would begin paying premiums on January 1, 2011.  If no participant pays any premium until January 1, 2013, then our estimates would be off by two years." You heard it here first! ***

*** AALTCI MAKES AVAILABLE LOW-COST E&O INSURANCE. A new, low-cost E&O (Errors and Omissions) protection program for insurance agents and brokers is now being offered through the American Association for Long-Term Care Insurance ( According to Jesse Slome, executive director for the organization, the cost for $1-million per-claim is $510-per-year. Covers life and health insurance sales including long-term care insurance and is available to producers in all states. For more information visit the Association's website: Membership in the Association is required. If you are not a member, be sure to enter our discount code "CENTER50" to save 50% off AALTCI's membership cost. ***

*** ONCE BURNED, TWICE CAUTIOUS? The July issue of ElderLawAnswers Monthly reports: "Reverse mortgage lenders are now routinely second-guessing the legitimacy of power of attorney (POA) documents, according to industry sources. Presented with an agent seeking to take out a reverse mortgage on behalf of an incompetent principal, banks or brokers are typically asking for a letter from the principal's doctor stating that the senior was competent at the time the POA was executed, or, failing that, a letter from the doctor indicating when the principal's condition began. Based on this information, the lender or broker decides whether or not to proceed with the reverse mortgage application." ELA Monthly asks "Illegal Discrimination?" But we wonder if this caution simply reflects the reverse mortgage industry's reasonable response to financial abuse of the elderly by relatives and their Medicaid planners using powers of attorney and guardianships. ***

*** JUST IN… According to her press release: "Industry leader Phyllis Shelton, President of LTC Consultants, will appear on Lifetime Television’s The Balancing Act on July 14 at 7 AM EST to set the record straight that the issue of long-term care is not solely a financial problem." Don’t miss this! Further note: She announces that her May conference on LTCI Worksite and Combo Products was so successful that she’ll be doing a seven city Fall Tour. All info is on her website: ***

*** SUBSCRIBE TO LTC BULLETS. Please encourage your colleagues to fill out the simple online subscription form at Subscriptions are free to everyone for the first month. After that, we'll ask you to help support the cause: rational long-term care public policy. ***



LTC Comment: Today, I begin the field work for our long-term care financing study in the Commonwealth of Pennsylvania. For a detailed description of this project, see "LTC Bullet: Center Begins Study in Pennsylvania," Wednesday, June 16, 2010. We are conducting this research in conjunction with the Commonwealth Foundation (CF), an independent, non-profit research and educational institute dedicated to limited government, economic freedom, and personal responsibility.

Today, Joshua Hoerner of CF and I will meet with a broad range of state Medicaid officials first thing in the morning. This meeting grew in size rapidly, so I added some extra time to accommodate the group. It has been difficult to pin down all the appointments we need within Pennsylvania's complex, fragmented and reorganizing Medicaid LTC program. We're hoping this first meeting will nail down the specialized sessions we need to schedule in the areas of Medicaid LTC financial eligibility policy, eligibility rules and implementation, and Medicaid liens and estate recoveries.

Immediately following this session with state officials, we'll meet with a series of long-term care provider associations including their executive directors and some members. Among these are the Pennsylvania Association for Non-profit Senior Services, the Pennsylvania Health Care Association and Center for Assisted Living Management, and the Pennsylvania Homecare Association (PHA). Also participating in the PHA in person and by conference call will be representatives of various senior advocacy groups.

On Wednesday, July 14, we'll meet with representatives of the Pennsylvania Insurance Department including Stephen Johnson, Deputy Insurance Commissioner, Office of Corporate and Financial Regulation; Carolyn Morris, Consumer Services Bureau Director, Office of Insurance Market Regulation; Peter Camacci, Accident and Health Bureau Director, Office of Insurance Product Regulation; and Rick Stoner, Accident and Health Bureau, Office of Insurance Product Regulation. Our goal is to learn about regulation of private long-term care insurance in the state and to understand any problems or challenges the market, producers, and consumers may face.

Later on Wednesday, we will convene with a group of Harrisburg business leaders to discuss the unique challenges local companies face with regard to LTC-related absenteeism or "presenteeism." We'll also ask about the LTC insurance coverage they offer or if none, why? We'll share some thoughts about the likely future of LTC financing and how the business community may be affected. We'll request feedback from the attendees.

On Thursday, July 15, I'll start the day with a briefing for state legislative staff interested in learning more about LTC policy, Medicaid expenditures and the CLASS Act. Vince Phillips, a well-known advocate for the Pennsylvania Association of Health Underwriters organized this session. Immediately thereafter, I will meet with long-term care insurance and reverse mortgage experts at the Commonwealth Foundation's headquarters. I'll be getting their perspective on the LTCI and RM markets in Pennsylvania. Special thanks to Center supporter and LTCI producer and advocate Ross Schriftman for organizing this session.

Later in the day, we'll finish with another LTC provider meeting. This time it will be with the Pennsylvania Assisted Living Association.

We've kept time slots open on Wednesday, Thursday and Friday to accommodate supplemental meetings and interviews to be identified during the week. Our goal is to draft a final report, at least one newspaper op-ed, and an article about our findings by the end of July. Then it's on to project #2 in California.