*** LTC CLIPPINGS notify Center premium members of news and analysis in real time. Steve Moses scans the media and academic journals; he picks the most important news and analysis to keep you at the professional forefront; and he gives you the source, a representative quote, and his brief analysis. A couple examples follow. Find our “Membership Levels and Benefits Schedule” here. Join the Center and become a premium member here. Or contact damon@centerltc.com for details.

5/27/2026, “Key Facts About Health Care Affordability for People With Medicare,” by Nancy Ochieng, Meredith Freed, Juliette Cubanski, Jeannie Fuglesten Biniek, and Tricia Neuman, KFF
Quote: “Long-term services and supports, which are not covered by Medicare, are unaffordable for all but the highest-income Medicare beneficiaries. In 2025, the median annual costs of common long-term services and supports in the U.S were $80,080 for full-time non-medical caregiver services (including home health aide and homemaker services for people who need help with instrumental activities of daily living such as preparing meals and doing laundry), $129,575 for a private room in a nursing home, and $305,760 for round-the-clock home health aide services (Figure 9). These costs greatly surpass median income ($43,200) and savings ($110,100) among people with Medicare. Long-term care services are generally not covered by Medicare, regardless of whether a beneficiary is enrolled in traditional Medicare or Medicare Advantage.”
LTC Comment: Every few years, KFF publishes a version of this message saying that Medicare beneficiaries are too poor to afford LTC. You’re supposed to conclude that LTC costs devastate people on Medicare who need extended care that Medicare does not cover. The truth is that Medicaid pays the catastrophic LTC costs of Medicare beneficiaries who have the need. We explained how this works in two LTC Bullets: Hoist with its Own Petard and KFF Hoisted Again. Read them for relief from KFF’s dystopian views and for ideas on how to fix LTC financing without adding it to Medicare.

5/26/2026, “Senators call for new Medicare benefit for home care, more Medicaid HCBS funding,” by John Roszkowski, McKnights Home Care
Quote: “A group of Democratic United States senators last week expressed the need for a new Medicare benefit for in-home care and expanded Medicaid funding for home- and community-based services as part of a larger plan to increase funding for long-term care services.”
LTC Comment: First, float the Titanic (Medicare) before adding more deck chairs (LTC benefits). ***

LTC BULLET: AN OPEN INVITATION TO LTC FRAUD

LTC Comment: Health care fraud is all over the news lately. Medicaid and Medicare are the fraudsters’ favorite targets. Medicaid LTC is especially vulnerable because most of it (87.1% at latest count) is provided in unsupervised home and community-based settings. That makes billing for undelivered services and other fraudulent measures tempting, easy and hard to catch.

The Centers for Medicare and Medicaid Services (CMS) is fighting a rearguard action to rein in health care fraud. The Administration’s Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) initiative and a Task Force to Eliminate Fraud aim to curtail fraud in CMS programs estimated to cost $100 billion per year. Some say these measures are too little, too late. Why hasn’t the government fought fraud more aggressively up to now?

Efforts to fight fraud in public benefit programs face many obstacles. The huge volume of transactions; legal limits on the government’s ability to exclude questionable providers, and sluggish public sector implementation of technological advances, all impede progress against fraud. Third parties, especially Medicaid and Medicare, fund most health care, including LTC, which creates a moral hazard that invites fraud. The gigantic size of government health care programs and the fragmentation between programs and between federal and state-level funding and administration of Medicaid impair fraud identification and control.

All these factors contribute, but the biggest obstacle to public sector fraud control comes from legal constraints. Medicaid and Medicare were created in 1965 as part of Lyndon Johnson’s Great Society war on poverty. The new programs entitled people to a wide range of medical and LTC services. After enactment, their costs exploded immediately. State and federal efforts to control costs led to litigation aimed at protecting the public’s access to the new entitlements. Two major court cases addressed this issue.

In Goldberg v. Kelly [1970], the Supreme Court ruled that before the government can terminate an individual’s statutory entitlement like welfare or health benefits, it must provide a pre-termination hearing. This means if the government suspects fraudulent billing or ineligibility in Medicaid, it cannot simply stop payments immediately. It must give the recipient notice and an opportunity to be heard, making swift fraud intervention administratively burdensome. Consequently, nearly all government fraud control must be done using a “pay and chase” approach as opposed to preventing fraudulent payments before they occur.

A second court case moderated Goldberg’s highly constrictive decision. In Mathews v. Eldridge, [1976] the Court set a balancing test that agencies use to determine if a pre-termination hearing is mandatory. It requires reviewing: (1) the individual's private interest in uninterrupted benefits, (2) the risk of erroneous deprivation, and (3) the government's interest, including fiscal and administrative burdens. Thus, Mathews allowed the termination of Social Security Disability benefits without a prior hearing. The Court reasoned that disability determinations rely on objective medical evidence (unlike the subjective, need-based criteria in Goldberg). Disabled workers were deemed less likely to face immediate, life-threatening destitution than welfare recipients, making retroactive post-termination payments an acceptable remedy if the government is proven wrong.

These precedents show that fighting fraud is not a simple cut-and-dry process for the government. Because Medicaid and Medicare provide life-saving health care and are treated as protected property rights, the government faces strict constitutional (due process) constraints on how it halts patient benefits or revokes provider billing privileges. Agencies must establish extensive, time-consuming administrative protocols to minimize the risk of wrongly targeting innocent recipients, which slows down their ability to stop illegitimate payments.

Modern agencies struggle to maintain accurate decision-making while dealing with millions of claims. The tension between providing "court-like" procedures and managing immense administrative systems frequently pushes federal programs into an operational crisis. Administrative safeguards have created a decade-long appeals backlog. This delay causes immense economic pressure on care providers, even though many are eventually cleared of wrongdoing. Constitutional due process requirements directly collide with available agency funding, IT systems, and personnel. 

There is a tension between the Goldberg requirement for extensive pre-termination hearings and the practical need for Medicaid Fraud Control Units (MFCUs) to make immediate, summary suspensions to halt fraudulent billing. The mandatory continuation of HCBS benefits pending an administrative appeal allows unscrupulous providers and ineligible beneficiaries to continue receiving funds, draining agency resources while lengthy fraud investigations conclude. Goldberg v. Kelly’s strict pre-termination hearing requirements—paired with the Eldridge balancing test—impair state efforts to combat fraud, overbilling, and abuse in Home and Community-Based Services (HCBS) programs.

Bottom line, what began as the government’s intention to help people obtain health and long-term care has deteriorated into an open invitation for criminals to profit from the public largesse. This outcome is only one example of a larger problem. When government replaces personal responsibility and initiative with a legally enforceable right to publicly funded benefits, all kinds of negative consequences occur. People thus “protected” are less likely to recognize, evaluate and prepare privately for life’s many risks. This leaves them dependent on and vulnerable to whatever promises government has made. The sad irony is that after decades of the U.S. government promising Social Security, Medicare and Medicaid, the American public is unprotected today against the increasingly likely retrenchment of those programs. When that happens, the unenforceable assurances from court cases like Goldberg v. Kelly and Mathews v. Eldridge will be cold comfort.

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Updated Tuesday, May 26, 10:03 AM (Pacific)
 
Seattle—

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LTC E-ALERT #26-017:  LTC NEWS AND COMMENT

LTC Comment:  Do you spend hours searching the internet for useful articles, key data, and relevant reports to keep you on the forefront of professional knowledge?  Do you lose business because you’re blindsided by clients or competitors who learn critical information before you do?  Here’s an antidote:

LTC Clippings:  The Center for Long-Term Care Reform notifies subscribers to our LTC Clippings service daily of information you need to know.  Each message contains only the critical facts about new publications:  a title, representative quote, a link to the original, and our analysis in a sentence or two.  To inquire or subscribe, contact Damon at 206-283-7036 or damon@centerltc.com.  Read testimonials by satisfied subscribers here.  To subscribe online, please click here.

LTC E-Alerts:  Once a week, we compile our daily LTC Clippings into a summary, email it to Center for Long-Term Care Reform members, and archive it in The Zone, our password-protected members-only website.  Center members also receive our weekly LTC Bullet op-ed.  To join the Center and receive all these benefits and more, contact Damon at 206-283-7036 or damon@centerltc.com.  

We no longer post our LTC E-Alerts on the Center’s public access website, but here’s what today’s LTC E-Alert contained:  links, quotes and comments on the following articles, reports, or data:

• 9 million older adults are missing out on $58 billion in help with food, medicine, daily costs

• Reed: Can these assets be saved?

• Guaranteed income streams better predictor of retirement stability than assets

• Senate Democrats Vow To Develop A Long-Term Care Reform Plan

• Policyholders Who Sold Their Life Insurance Received Nearly 9x More Than Insurers Offered In 2025

• IRS Starts to Implement a Long-Term Care Insurance Tax Incentive

• Call for public consultation on Global Standards for Long-Term Care

• Fixing long-term care coverage

• Long-Term Care Claimant Was Working Full Time in Demolition, Transamerica Says

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"LTC E-Alerts" are a feature offered by the Center for Long-Term Care Reform, Inc. to members at the $150 per year level or higher.  We'll track and report to you news and analysis regarding long-term care financing, service delivery, and research.  We hope The LTC E-Alerts will help you attain and maintain a high level of knowledge and competency in this complex field.  The Center for Long-Term Care Reform, Inc. is a private institute dedicated to ensuring quality LTC for all Americans (www.centerltc.com).

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Updated Monday, May 18, 10:03 AM (Pacific)
 
Seattle—

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LTC E-ALERT #26-016:  LTC NEWS AND COMMENT

LTC Comment:  Do you spend hours searching the internet for useful articles, key data, and relevant reports to keep you on the forefront of professional knowledge?  Do you lose business because you’re blindsided by clients or competitors who learn critical information before you do?  Here’s an antidote:

LTC Clippings:  The Center for Long-Term Care Reform notifies subscribers to our LTC Clippings service daily of information you need to know.  Each message contains only the critical facts about new publications:  a title, representative quote, a link to the original, and our analysis in a sentence or two.  To inquire or subscribe, contact Damon at 206-283-7036 or damon@centerltc.com.  Read testimonials by satisfied subscribers here.  To subscribe online, please click here.

LTC E-Alerts:  Once a week, we compile our daily LTC Clippings into a summary, email it to Center for Long-Term Care Reform members, and archive it in The Zone, our password-protected members-only website.  Center members also receive our weekly LTC Bullet op-ed.  To join the Center and receive all these benefits and more, contact Damon at 206-283-7036 or damon@centerltc.com.  

We no longer post our LTC E-Alerts on the Center’s public access website, but here’s what today’s LTC E-Alert contained:  links, quotes and comments on the following articles, reports, or data:

• AARP report says state of assisted living sector is ‘cause for concern,’ but industry says it helps residents ‘live well’

• My dad's dementia care costs $9,000 a month. I'm selling my parents' home to pay for it

• White House cuts $1.3 billion in Medicaid payments to California

• Medicare’s 6-month enrollment freeze on home health and hospice: What senior living providers need to know

• Genworth's CareScout Unit Gets a Line in the Financial Report

• Eighth Circuit hands Unum a clean win on long-term-care denial

• [Updated] CMS issues six-month moratorium on new hospices, home health agencies nationwide

• Housing costs affect older adults’ ability to pay for assisted living, and here’s where costs hit hardest

• State Reverses Managed Medicaid for Nursing Homes After $91M Cost Spike in First Year

• New ‘economic architecture’ needed for aging population, report says

• Financial Shocks, Caregiving Gaps and Inflation Pressures Persist For Retirees

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"LTC E-Alerts" are a feature offered by the Center for Long-Term Care Reform, Inc. to members at the $150 per year level or higher.  We'll track and report to you news and analysis regarding long-term care financing, service delivery, and research.  We hope The LTC E-Alerts will help you attain and maintain a high level of knowledge and competency in this complex field.  The Center for Long-Term Care Reform, Inc. is a private institute dedicated to ensuring quality LTC for all Americans (www.centerltc.com).

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Updated Friday, May 15, 2026, 10:03 AM (Pacific)
 
Seattle—

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LTC BULLET: PROTECTING WHAT MATTERS

LTC Comment: Today’s LTC Bullet is a shout out to LTC insurance maven and radio-talk-show host Barry Fisher along with a link to our latest online conversation, after the ***news.***

*** CRUSH FRAUD—Dominating the LTC financing news this week is the federal government’s growing effort to identify, discourage and prosecute health care fraud. Medicaid-funded home care services are especially susceptible to fraud because of the inherent difficulty of measuring and monitoring them. LTC Clippings recently highlighted some of the fraud news. Examples follow. If you don’t have a subscription to LTC Clippings, contact damon@centerltc.com or call 206-283-7036. Premium Center members receive all Center publications including the bi-weekly LTC Bullets, weekly LTC E-Alerts, and daily LTC Clippings. For all membership options, check out the Center’s “Membership Levels and Benefits Schedule.”

5/13/2026, “White House cuts $1.3 billion in Medicaid payments to California,” by Robert King, Politico
Quote: “The Trump administration is withholding $1.3 billion in Medicaid reimbursements to California for failing to combat fraud, escalating a feud with the state over its management of hospice care. … Though the administration has repeatedly criticized California’s fraud oversight, this is the first time the Centers for Medicare and Medicaid Services has targeted payments to the state.”
LTC Comment: Do you think that’s excessive? Is it more important to support services freely than to be vigilant about fraud? That’s the attitude of some who criticize the current crackdown. Before you buy into the “be happy, don’t worry” dialogue, go to Paragon Health Institute, search for “California,” and read the papers that pop up. Check out Paragon’s Health Care Fraud Dashboard. And don’t miss Paragon president Brian Blase’s interview of Dr. Mehmet Oz, Administrator of CMS.

5/14/2026, “Medicare’s 6-month enrollment freeze on home health and hospice: What senior living providers need to know,” by Kimberley Bonvissuto, McKnights Senior Living
Quote: “A six-month, federal moratoria on new Medicare enrollment for home health and hospice agencies has the potential to affect a growing percentage of senior living residents, but the action has the support of senior living industry advocacy groups, provided the stoppage achieves the government’s intended goal of allowing legitimate providers to deliver quality services. The Centers for Medicare & Medicaid Services announced the moratoria on Wednesday, effective immediately, in an effort to ‘protect Medicare beneficiaries and taxpayer dollars.’ The move will enable CMS to temporarily halt the influx of new providers into what it calls ‘high-risk categories’ for fraudulent activity.”
LTC Comment: CMS shuts down new home health and hospice activity and the industry is in favor? Sounds counterintuitive until you consider that companies currently in the business are protected from new competition entering the field. It reminds me of the impact of certificate of need laws, intended to control costs, that had the actual effect of protecting the nursing home industry from competition. Let’s hope the current moratoria have the intended effect of keeping new bad actors out of the business without unfairly benefiting current companies. ***

LTC BULLET: PROTECTING WHAT MATTERS

LTC Comment: Barry Fisher, of Blaze ‘n Bear Insurance Services, Inc., is a longtime friend and fellow fighter to improve long-term care. Barry’s insurance career spans more than four decades working in the field of personal financial well-being and responsibility. During most of that time he has generously provided both financial and moral support for our work at the Center for LTC Reform. With broad expertise in life, disability and long-term care insurance he works with individuals, business owners and allied professionals helping them provide protection for themselves and those they care about. Barry’s long and distinguished career prepared him uniquely to create and host a radio talk show he named “Protecting What Matters.”

“Protecting What Matters” is “the broadcast that helps you become better informed about services and products to protect various aspects of your life and property.” Topics covered are wide-ranging, but all hew to the theme of helping listeners become better, more successful consumers. Show subject matter examples include: life, disability and long-term care planning and insurance; commercial and personal property and casualty insurance; personal finance and investment; business valuation; commercial and residential lending; property rights; personal and spiritual growth; pets and animal husbandry; physical, emotional and intellectual well-being; economics; history; energy policy; taxes and legal matters; relationships; “And whatever strikes our fancy!”

Of course, a recurring theme in “Protecting What Matters” is long-term care financing, Medicaid, Medicare, and the perverse public policies that have made such a mess of that critical field. Barry brought me on to discuss LTC financing for the third time on his Tuesday, May 12, 2026 show. You can hear what we had to say here. Just scroll down until you see the Audio Player. Our section on LTC begins at 27 minutes, 24 seconds into the program.

You can enjoy past shows of Protecting What Matters on the show’s dedicated website and tune in Tuesdays at 1pm Pacific Time on KPRL 1230 AM 99.3FM or listen to the live feed here.

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Updated Monday, May 11, 10:03 AM (Pacific)
 
Seattle—

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LTC E-ALERT #26-015:  LTC NEWS AND COMMENT

LTC Comment:  Do you spend hours searching the internet for useful articles, key data, and relevant reports to keep you on the forefront of professional knowledge?  Do you lose business because you’re blindsided by clients or competitors who learn critical information before you do?  Here’s an antidote:

LTC Clippings:  The Center for Long-Term Care Reform notifies subscribers to our LTC Clippings service daily of information you need to know.  Each message contains only the critical facts about new publications:  a title, representative quote, a link to the original, and our analysis in a sentence or two.  To inquire or subscribe, contact Damon at 206-283-7036 or damon@centerltc.com.  Read testimonials by satisfied subscribers here.  To subscribe online, please click here.

LTC E-Alerts:  Once a week, we compile our daily LTC Clippings into a summary, email it to Center for Long-Term Care Reform members, and archive it in The Zone, our password-protected members-only website.  Center members also receive our weekly LTC Bullet op-ed.  To join the Center and receive all these benefits and more, contact Damon at 206-283-7036 or damon@centerltc.com.  

We no longer post our LTC E-Alerts on the Center’s public access website, but here’s what today’s LTC E-Alert contained:  links, quotes and comments on the following articles, reports, or data:

• New ASHA publication helps industry disprove senior living, home care misconceptions

• My Beloved Husband Has Early-Stage Dementia. He Is 'Doing Well,' but How Do I Protect Our $1.6 Million Savings Right Now?

• Rural residents less likely to receive HCBS than urban counterparts, study finds

• Long-Term Care Costs Are Hollowing Out Generational Wealth

• Majority Of Americans At Risk Of Outliving Their Retirement Savings

• Study: Poor housing affordability associated with higher risks of frailty, mortality

• Medicaid self-directed care has a fraud problem, Addus CEO says

• What To Do About Medicaid’s Long-Term Care Benefit?

• Family caregiving inflicts emotional, financial toll, new US News survey finds

• The Old Guard 

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"LTC E-Alerts" are a feature offered by the Center for Long-Term Care Reform, Inc. to members at the $150 per year level or higher.  We'll track and report to you news and analysis regarding long-term care financing, service delivery, and research.  We hope The LTC E-Alerts will help you attain and maintain a high level of knowledge and competency in this complex field.  The Center for Long-Term Care Reform, Inc. is a private institute dedicated to ensuring quality LTC for all Americans (www.centerltc.com).

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Updated Monday, May 4, 10:03 AM (Pacific)
 
Seattle—

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LTC E-ALERT #26-014:  LTC NEWS AND COMMENT

LTC Comment:  Do you spend hours searching the internet for useful articles, key data, and relevant reports to keep you on the forefront of professional knowledge?  Do you lose business because you’re blindsided by clients or competitors who learn critical information before you do?  Here’s an antidote:

LTC Clippings:  The Center for Long-Term Care Reform notifies subscribers to our LTC Clippings service daily of information you need to know.  Each message contains only the critical facts about new publications:  a title, representative quote, a link to the original, and our analysis in a sentence or two.  To inquire or subscribe, contact Damon at 206-283-7036 or damon@centerltc.com.  Read testimonials by satisfied subscribers here.  To subscribe online, please click here.

LTC E-Alerts:  Once a week, we compile our daily LTC Clippings into a summary, email it to Center for Long-Term Care Reform members, and archive it in The Zone, our password-protected members-only website.  Center members also receive our weekly LTC Bullet op-ed.  To join the Center and receive all these benefits and more, contact Damon at 206-283-7036 or damon@centerltc.com.  

We no longer post our LTC E-Alerts on the Center’s public access website, but here’s what today’s LTC E-Alert contained:  links, quotes and comments on the following articles, reports, or data:

• At the Tipping Point: Liberating a New Age of Aging

• New Law Caps Home Equity for Medicaid Long-Term Care

• Alzheimer’s deaths have more than doubled between 2000 and 2024, new report finds

• The Association of Medicaid Estate Recovery with Homeownership, Home Equity, and Medicaid Enrollment

• Kennedy’s recent comments on paid family caregivers ‘deeply concerning,’ advocates say

• Medicaid Waste, Fraud, and Abuse: Why CMS’s Improper Payment Rate Can’t Be Trusted

• BREAKING NEWS: CMS issues updated 2026 spousal impoverishment standards

• The longevity revolution is here. Our systems still think we die at 65

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"LTC E-Alerts" are a feature offered by the Center for Long-Term Care Reform, Inc. to members at the $150 per year level or higher.  We'll track and report to you news and analysis regarding long-term care financing, service delivery, and research.  We hope The LTC E-Alerts will help you attain and maintain a high level of knowledge and competency in this complex field.  The Center for Long-Term Care Reform, Inc. is a private institute dedicated to ensuring quality LTC for all Americans (www.centerltc.com).

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Updated Friday, May 1, 2026, 10:03 AM (Pacific)
 
Seattle—

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LTC BULLET: BRIDGING LTC SILOS

LTC Comment: LTC providers and insurers communicate too little, hewing jealously to their professional bailiwicks. We try to narrow the gap after the ***news.*** 

*** LTC CLIPPINGS:  Did you catch these stories this week?  Our LTC Clippings subscribers received them in real time including Steve Moses’s always trenchant, often ironic, sometimes humorous, usually concise “LTC Comments.”  To subscribe or for a free trial, contact Damon at 206-283-7036 or damon@centerltc.com. Examples below:

4/28/2026, “New Law Caps Home Equity for Medicaid Long-Term Care,” by Lee Pruitt, ElderLawAnswers

Quote: “A new federal law, effective in 2028, will cap the amount of home equity a person can have and still qualify for Medicaid long-term care at $1 million. This $1 million limit will not increase with inflation, meaning more homeowners will be affected over time as property values rise. If your home equity is near or above $1 million, consult an elder law attorney now to explore options like reverse mortgages or legal transfers before the 2028 deadline.”

LTC Comment: Good advertising hook for Medicaid planners, huh? An open invitation to ignore private LTC insurance and rely on taxpayers to protect home equity from LTC risk. What’s even worse, the same Medicaid planners will tell people with less home equity and a lot of cash to convert the countable cash to exempt status by added spending on the home. After they pay the attorney’s fee first, which is also exempt. Just another example of “What’s Worse than Medicaid Fraud.”

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4/27/2026, “Medicaid Waste, Fraud, and Abuse: Why CMS’s Improper Payment Rate Can’t Be Trusted,” by Chris Medrano and Brian Blase, Paragon Health Institute

Quote: “Medicaid’s improper payment rate is widely misunderstood. PERM provides a narrow compliance estimate and is not a reliable measure of waste, fraud, abuse, or total improper payments in Medicaid. Major gaps in eligibility determinations and managed care payments make PERM incomplete. The program does not fully capture eligibility errors and fails to examine managed care payments at the provider level—despite managed care representing the majority of Medicaid spending. Low reported error rates risk creating a false sense of security. Because PERM relies on limited samples and lagged data, its findings understate risks and the scale of improper payments. Policymakers should strengthen PERM to improve accountability and enable enforcement actions in Medicaid.”

LTC Comment: Bottom line: no one knows how much fraud, waste and abuse permeate Medicaid because such limited measurements as exist are fatally flawed. How refreshing that this critical subject is finally getting the attention it deserves. ***

LTC BULLET: BRIDGING LTC SILOS

LTC Comment: Have you noticed how little the people and companies responsible for providing long-term care (LTC) communicate with the people and companies responsible for funding LTC?  You would think these two industries should have much to discuss. Nursing homes and home health agencies desperately need revenue. LTC insurers struggle to attract buyers. But the two professions rarely work together.

Both face a common problem. Medicaid pays LTC providers too little, often less than the cost of providing the care. Easy access to Medicaid when care is needed crowds out demand for private LTC insurance. Logically, LTC providers and insurers would unite and mobilize to advocate for policies that target Medicaid benefits to the neediest Americans and divert the well-to-do toward private financing, so that they pay economically sustainable market rates.

The Center for Long-Term Care Reform has published dozens of national and state-level studies proposing policy solutions along those lines. Most recently, “Long-Term Care: The Problem” and “Long-Term Care: The Solution” with the Paragon Health Institute. At the same time, we have placed articles and columns in trade journals and other publications intended to link the interests of LTC providers and insurers. Following are some examples from October 2021 through April 2024. We hope you’ll open and read some of them and that they will help tie together the interests and policies of LTC providers and insurers.

1. “The Medicaid LTC snafu,” by Stephen A. Moses, McKnights LTC News, April 15, 2024 (PDF version.) This article shows how Medicaid’s generous eligibility rules allow people with significant income and assets to use Medicaid’s scarce resources.
2. “Setting the Record Straight on Long-Term Care Policy,” by Stephen A. Moses and Brian Blase, Townhall, April 14, 2024 (PDF version.) This article debunks the claim, presented in The New York Times’ recent series Dying Broke, that catastrophic long-term care expenses are wiping out the savings of American middle-class families.
3. “How government prevaricates about long-term care,” by Stephen A. Moses, McKnights LTC News, February 23, 2024 (PDF version.) This article explores the biases in how federal officials and the media report long-term care expenditures. It deconstructs the conventional wisdom about out-of-pocket spending data. 
4. “Government must encourage personal responsibility, prohibit easy access to Medicaid,” by Steve Moses and Brian Blase, Washington Times, November 30, 2023. (PDF version.) Save Medicaid LTC for the needy by engaging self-interest and personal responsibility.
5. “The federal Medicaid bait and switch,” by Stephen A. Moses, McKnight’s LTC News, November 6, 2023. (PDF version.) Medicaid promised LTC providers generous revenue but reneged creating shortfalls that hurt providers and consumers.
6. "What’s Wrong With Long-Term Care?," by Stephen A. Moses, RealClear Policy, November 2, 2022. (PDF version.) This article is a succinct explanation of what’s wrong with our long-term care system and how to fix it.
7. “LTC insurance sales suddenly surge,” by Stephen A. Moses, McKnight’s LTC News, August 10, 2022. (PDF version.) It took Washington State’s public long-term care insurance program to excite private LTC insurance demand in that state to unbelievable levels. This article explores this curious phenomenon and its important public policy implications.
8. “Long-term care’s mortal risk,” by Stephen A. Moses, McKnight’s LTC News, June 6, 2022. (PDF version.) What if our long-term care system collapses? This article explores how feeble our long-term care system actually is.
9. “Long-Term Care Epiphany,” by Stephen A. Moses, Broker World, June 2022. (PDF version.) What if the so-called “long-term care crisis” was really “no biggie”? This article reconceptualizes the LTC conundrum and provides a solution.
10. “Trappings of LTC system leave operators trapped,” by Stephen A. Moses, McKnight’s Long-Term Care News, February 23, 2022. (PDF version.) This article is a “thought experiment” exploring how a true free market can vastly improve our long-term care system.
11. “The Great Long-Term Care Compromise,” by Stephen A. Moses, Broker World, January 1, 2022. (PDF version.) Using Washington State’s WA Cares as a model, this article shows how to solve the long-term care crisis by mandating people to choose between social or private LTC insurance.
12. “The irony of long-term care advocacy,” by Stephen A. Moses, McKnight’s Long-Term Care News, December 17, 2021. (PDF version.) This article examines the disconnect between the long-term care people want and the long-term care public policy they get.
13. “Long Term Care Irony,” by Stephen A. Moses, Broker World, December 1, 2021. (PDF version.) When forced to choose between public and private options for long-term care, Washington State saw an unprecedented influx of private LTCi applications. This article examines the historical context and primary LTC myth driving such consumer behavior.  
14. “What works for long-term care and what doesn’t,” by Stephen A. Moses, McKnight’s LTC News, November 17, 2021. (PDF version.)
    This article gives a historical perspective of what’s gone wrong with public financing of long-term care and how private financing can improve it.
15. “What’s better for senior living and care — the market or government?,” by Stephen A. Moses, McKnight’s Senior Living, October 25, 2021. (PDF version.)
    This article explains why and how markets succeed while government usually fails.

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Updated Monday, April 27, 2026, 10:03 AM (Pacific)
 
Seattle—

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LTC E-ALERT #26-013:  LTC NEWS AND COMMENT

LTC Comment:  Do you spend hours searching the internet for useful articles, key data, and relevant reports to keep you on the forefront of professional knowledge?  Do you lose business because you’re blindsided by clients or competitors who learn critical information before you do?  Here’s an antidote:

LTC Clippings:  The Center for Long-Term Care Reform notifies subscribers to our LTC Clippings service daily of information you need to know.  Each message contains only the critical facts about new publications:  a title, representative quote, a link to the original, and our analysis in a sentence or two.  To inquire or subscribe, contact Damon at 206-283-7036 or damon@centerltc.com.  Read testimonials by satisfied subscribers here.  To subscribe online, please click here.

LTC E-Alerts:  Once a week, we compile our daily LTC Clippings into a summary, email it to Center for Long-Term Care Reform members, and archive it in The Zone, our password-protected members-only website.  Center members also receive our weekly LTC Bullet op-ed.  To join the Center and receive all these benefits and more, contact Damon at 206-283-7036 or damon@centerltc.com.  

We no longer post our LTC E-Alerts on the Center’s public access website, but here’s what today’s LTC E-Alert contained:  links, quotes and comments on the following articles, reports, or data:

• CMS asks states to submit Medicaid provider revalidation strategies, increase oversight

• Medigap Premiums Leap, and Consumers Have Few Alternatives

• Dr. Oz announces a 50-state audit of Medicaid program oversight

• Exploring Early Uses of Artificial Intelligence in Long-Term Care Systems

• House hearing highlights ‘systemic failure’ at heart of hospice, home health fraud

• Americans Believe They Will Need $1.46 Million to Retire Comfortably

• Needing long-term care in retirement one of Americans’ greatest fears, survey finds

• State indicts 9 people on charges of fraud and theft involving Medicaid

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"LTC E-Alerts" are a feature offered by the Center for Long-Term Care Reform, Inc. to members at the $150 per year level or higher.  We'll track and report to you news and analysis regarding long-term care financing, service delivery, and research.  We hope The LTC E-Alerts will help you attain and maintain a high level of knowledge and competency in this complex field.  The Center for Long-Term Care Reform, Inc. is a private institute dedicated to ensuring quality LTC for all Americans (www.centerltc.com).

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Updated Monday, April 20, 2026, 10:03 AM (Pacific)
 
Seattle—

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LTC E-ALERT #26-012:  LTC NEWS AND COMMENT

LTC Comment:  Do you spend hours searching the internet for useful articles, key data, and relevant reports to keep you on the forefront of professional knowledge?  Do you lose business because you’re blindsided by clients or competitors who learn critical information before you do?  Here’s an antidote:

LTC Clippings:  The Center for Long-Term Care Reform notifies subscribers to our LTC Clippings service daily of information you need to know.  Each message contains only the critical facts about new publications:  a title, representative quote, a link to the original, and our analysis in a sentence or two.  To inquire or subscribe, contact Damon at 206-283-7036 or damon@centerltc.com.  Read testimonials by satisfied subscribers here.  To subscribe online, please click here.

LTC E-Alerts:  Once a week, we compile our daily LTC Clippings into a summary, email it to Center for Long-Term Care Reform members, and archive it in The Zone, our password-protected members-only website.  Center members also receive our weekly LTC Bullet op-ed.  To join the Center and receive all these benefits and more, contact Damon at 206-283-7036 or damon@centerltc.com.  

We no longer post our LTC E-Alerts on the Center’s public access website, but here’s what today’s LTC E-Alert contained:  links, quotes and comments on the following articles, reports, or data:

• What’s worse than Medicaid fraud?

• Henry Paulson Says U.S. Should Prepare for a 'Vicious' Bond Crash

• Alternative Contingency Policies for When the Social Security Trust Fund Is Exhausted

• The Trump Administration’s Anti-Waste in Health Care Campaign

• $5,400 a Month for Assisted Living Is the New Reality—How Families Are Making It Work

• Report: Home health providers ordered to pay over $100M in restitution for fraud in 2025

• America Built No System For Aging: The Largest Generation In History Just Started Turning 80 

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"LTC E-Alerts" are a feature offered by the Center for Long-Term Care Reform, Inc. to members at the $150 per year level or higher.  We'll track and report to you news and analysis regarding long-term care financing, service delivery, and research.  We hope The LTC E-Alerts will help you attain and maintain a high level of knowledge and competency in this complex field.  The Center for Long-Term Care Reform, Inc. is a private institute dedicated to ensuring quality LTC for all Americans (www.centerltc.com).

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Updated Friday, April 17, 2026, 10:03 AM (Pacific)
 
Seattle—

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LTC BULLET: LTC INSURANCE FRAUD

LTC Comment: As health insurance fraud surges nationwide, we consider how it impacts LTC insurance in the private and public sectors after the ***news.***

*** LTC CLIPPINGS:  Did you catch these stories recently? Our LTC Clippings subscribers received them in real time including Steve Moses’s trenchant, often ironic, sometimes humorous, usually concise “LTC Comments.” To subscribe or for a free trial, contact Damon at 206-283-7036 or damon@centerltc.com. Examples below:

4/13/2026, “Report: With spend-down of assets, US long-term care system ‘effectively penalizes aging’,” by Kathleen Steele Gaivin, McKnights Senior Living

Quote: “Costs associated with the provision of long-term care in a system that requires lower- and middle-class older adults to spend down their assets to pay for home care or life in an assisted living community or skilled nursing facility perpetuates ‘cycles of wealth inequality,’ making it difficult for future generations to build financial security, according to a new study published by the Roosevelt Institute. … ‘This spend-down process interrupts the potential for intergenerational wealth building, after what is often a lifetime of work and saving by low-income and middle-class families, perpetuating cycles of wealth inequality,’ Forden said. ‘Meanwhile, these costs are increasingly captured by profit-driven corporations and private equity firms.’”

LTC Comment: Medicaid asset spend down is the most misunderstood concept in LTC financing jargon. It crushes the poor and lower middle class but gives the middle-class and affluent an off ramp. Unlike income spend down that requires spending for care, asset spend down can be done simply by using countable wealth to purchase exempt resources. I explained how that works and estimated how much it costs Medicaid (and taxpayers) in “Medicaid’s $100+ Billion Leak.” Blaming “profit-driven corporations” for the damage spend down does to those in need is just socialist claptrap. It’s the “progressive” political proclivity to give everything to everyone and print the money to pay for it that is the root of the problem. To make sense of what ails LTC, read the Paragon Health Institute’s “Long-Term Care: The Problem” and “Long-Term Care: The Solution” and watch this “virtual LTC event” featuring age wave visionary Ken Dychtwald and leading LTC researchers. To find ample private funds for LTC, check out “Medicaid’s $100+ Billion Leak.” For what not to do, see “Medi-Cal-amity: California’s Reckless Expansion of Medicaid Long-Term Care to the Affluent.” Much more on long-term care here. ***

4/16/2026, “Henry Paulson Says U.S. Should Prepare for a 'Vicious' Bond Crash,” by Christopher Amstey, Financial Advisor

Quote: “Former Treasury Secretary Henry Paulson called on U.S. authorities to prepare a back-up plan in order to avert a potential collapse in demand for Treasuries — an event that he warned would have ‘vicious’ effects. … U.S. budget experts have for years warned of the potential for a ‘doom loop,’ where investors start demanding higher yields on Treasuries due to risks tied to the government’s swelling debt burden, which then causes an increase in the government’s interest payments — in turn widening the deficit. … ‘It’s going to take increased revenues, taxes, and dealing with expenses,’ he said. It would also mean overhauling Social Security and health care programs, he said. ‘You can raise the revenues without a big drag on growth, if you close preferences and loopholes in the tax code.’”

LTC Comment: Remember when Modern Monetary Theory told us the U.S. government could spend without restraint by printing money to fill funding gaps? Whoops! Turns out there’s a limit to that strategy. When you borrow so much that no one is willing to loan you more, you’re stuck. This reality is what will finally force America to confront problems like out-of-control entitlement spending. The good news is that we have plenty of realistic solutions to draw from to fix LTC.

LTC BULLET: LTC INSURANCE FRAUD

LTC Comment: LTC insurance fraud was a frequent topic at the recent Intercompany Long-Term Care Insurance (ILTCI) conference in Orlando, Florida. We covered that conference and its fraud sessions in detail a couple weeks ago in LTC Bullet: ILTCI 2026 Virtual Visit.

In the meantime, your Center for Long-Term Care Reform has started digging deeper into LTC insurance fraud. We’re especially interested in measures LTCI carriers have taken to identify, mitigate, and prosecute fraud. We will conduct a literature search and interview some of the experts who presented at the ILTCI meeting. We also invite anyone with expertise on this topic to share your insights and suggestions by contacting smoses@centerltc.com.

Our special interest in this topic is to identify best fraud control practices developed by private LTCI carriers that may be transferable to ameliorate the much bigger problem in public programs, especially Medicaid and Medicare. For now, we’re scoping out the general subject of health care fraud. These are some of the issues, suggested by AI, that we plan to explore in a draft paper and op-eds.

Insurance Fraud Incidence
Finding precise, "hard" data for long-term care (LTC) fraud is challenging because it is often grouped into broader "healthcare fraud" or "improper payment" categories. However, recent industry reports and government snapshots provide these estimated figures for 2023–2025:

Private Sector LTC Insurance Fraud
In the private sector, fraud is often measured as a percentage of total claims paid.

• Estimated Fraud Rate: Experts from firms like illumifin and the Coalition Against Insurance Fraud estimate that 5% to 10% of all LTC insurance claims involve some form of fraud, waste, or abuse.
• Financial Impact: With the industry paying approximately $14.1 billion in benefits in 2023, the estimated annual loss to fraud is roughly $700 million to $1.4 billion.
• Case Severity: For sentenced healthcare fraud cases in 2024, the median loss per case was approximately $2.5 million, with nearly 20% of cases involving losses over $9.5 million. 

Health Care Fraud
LTCi becoming more of a target for fraud
What Data Says About Health Care Fraud 

Public Sector (Medicare & Medicaid) LTC Fraud
The public sector primarily tracks "Improper Payment Rates." It is critical to note that while improper payments include fraud, they also encompass administrative errors like missing documentation. 
Medicare Program Integrity and Efforts to Root Out Improper Payments, Fraud, Waste and Abuse
Fiscal Year 2024 Improper Payments Fact Sheet

• Medicaid (FY 2025 Estimates):
  • Improper Payment Rate: 6.12% ($37.39 billion), an increase from 5.09% in FY 2024.
  • Fraud Specifically: Of these improper payments, only a fraction is confirmed fraud. Most (over 77%) are attributed to insufficient documentation.
• Medicare (FY 2025 Estimates):
  • Fee-for-Service (FFS): 6.55% ($28.83 billion).
  • Medicare Advantage (Part C): 6.09% ($23.67 billion), often due to lack of documentation for diagnoses.
• Enforcement Outcomes (FY 2024): State Medicaid Fraud Control Units (MFCUs) reported 1,151 convictions and recovered $1.4 billion. 

5 Key Facts About Medicaid Program Integrity – Fraud, Waste, Abuse and Improper Payments
Fiscal Year 2025 Improper Payments Fact Sheet
Medicaid Fraud Control Units Annual Report: Fiscal Year 2024
Improper Payments and Fraud: How They Are Related but Different
Types of Corporate Fraud

Fraud Tolerance
There is evidence suggesting that a segment of the public, particularly younger generations, has developed a higher tolerance for certain types of non-violent fraud, such as insurance fraud and digital scams. While many still view these actions as illegal, studies indicate a growing trend of rationalizing or accepting "lower-level" fraud, often viewing it as a victimless crime against large, wealthy corporations rather than individuals. 

Survey Finds Younger Generations Have a Higher Tolerance For Insurance Fraud – What Insurers Should Know

Fraud Types Shared by Public and Private Insurers

• "Phantom" care and billing: Submitting claims for services never provided, such as x-rays, drugs, or home care hours.

•  Upcoding: Misrepresenting a patient's diagnosis or severity to bill for a higher rate of reimbursement.

• Medical Identity Theft: Fraudsters visiting facilities to collect Medicare or Medicaid numbers under the guise of offering "free" services, later used for bogus billing.

• Kickbacks: Financial incentives given to physicians or facilities to steer patients toward specific high-cost therapies or services.

• These practices often involve predatory actors working on both the public and private sides.

Common Red Flags

• Early Duration Claims: Claims filed soon after a policy is purchased.
• Unusual Billing: Inconsistent, high, or rapidly increasing hours.
• Pressure Tactics: Salespeople rushing decisions or pushing to handle all documentation.
• Too-Good-To-Be-True: Policies promising to cover everything. 

Around 38.5% of companies surveyed reported provider misrepresentation of services as a significant risk. 

Critical Vulnerability: Cognitive Impairment 
A major finding in current research is that populations with diminished capacity are disproportionately targeted. Both private and public sectors are now prioritizing caregiver-specific audits and specialized training for claim examiners to detect when a patient is being manipulated into signing falsified logs or timesheets. Common LTC Fraud Schemes Targeting Vulnerable Seniors

Private Sector Lessons Transferable to the Public Sector
Private insurers have pioneered several strategies that are now considered best practices for public side enforcement: 6 Claims Best Practices for Life Insurance Fraud Prevention

• Electronic Visit Verification (EVV): Originally a private-sector tool, Medicaid now mandates EVV to use GPS data to ensure caregivers are physically present at the reported time and location. Innovation and Long-Term Care Insurance (Robert Eaton)
• Predictive Analytics & AI: Public agencies like the DOJ and HHS-OIG are scaling machine learning tools—similar to those used by private actuaries—to flag outlier billing and risk-adjustment irregularities in real-time. Healthcare Fraud Enforcement Trends to Expect in 2026
• Cross-Sector Collaboration: The National Association of Insurance Commissioners (NAIC) and the Coalition Against Insurance Fraud emphasize that sharing fraud data between private carriers and government regulators is essential for identifying "double billing" rings that target both systems simultaneously.
• Focused Field Surveillance: Private insurers often use targeted surveillance for suspicious home care claims; public programs are increasingly using similar "Strike Force" tactics to investigate high-risk geographic clusters. 

The public sector can enhance its anti-fraud efforts by adopting the private sector’s focus on individual-level behavioral verification and formalized cross-payer data integration. While programs like Medicare and Medicaid excel at large-scale algorithmic detection, private insurers often utilize more "on-the-ground" investigative techniques that can identify sophisticated schemes where the billing data itself appears legitimate. 
Fraud Control in the Health Care Industry: Assessing the State of the Art

1. Shift from "Pay and Chase" to Real-Time Prevention
The public sector can adopt private-sector strategies to move from reactive recovery to proactive prevention:

• Adopting "Pre-Payment" Edits: Private insurers use sophisticated "claim scrubbing" applications to flag anomalies before payment is issued. Implementing similar real-time root-cause analysis in public systems can reduce the need for expensive post-payment investigations.
• Electronic Visit Verification (EVV) Optimization: Public programs can learn from private insurers' use of GPS and biometric data to ensure caregivers are physically present at the reported care location, a key defense against "phantom" billing. 

Public-Private Partnership to Prevent Health Care Fraud Announced by Health and Human Services
Best practices for employers to combat claims-related healthcare fraud
Long-Standing State-Based Efforts to Combat Fraud Against Medicaid Continue to Improve

2. Enhanced Behavioral and Field Investigations
Private insurers often identify fraud by looking beyond the billing codes to the actual lifestyle and behavior of the parties involved: 

• Targeted Surveillance: Private sector "field investigations" frequently uncover fraud—such as patients performing activities they claim to be unable to do—that purely data-driven public audits might miss.
• Caregiver-Specific Audits: Focusing research on the caregiver’s lifestyle, professional licensing, and historical litigation can uncover systemic fraud rings. 

Long-Standing State-Based Efforts to Combat Fraud Against Medicaid Continue to Improve

3. Formalized Information Sharing Networks
Public-private partnerships are the most direct way for the public sector to benefit from private-sector progress:

• Healthcare Fraud Prevention Partnership (HFPP): This voluntary program allows federal and state agencies to share data with private plans to gain a "cross-payer" view. This helps identify "double billing" where a provider bills both a private LTC policy and Medicare for the same service on the same day.
• Unified Fraud Hotspots: By sharing data on specific suspicious billing codes and geographic fraud "hotspots," the public sector can direct its high-intensity enforcement teams more effectively. 

About the Partnership
Public-Private Partnership to Fight Fraud Formed
Public-Private Partnership to Fight Fraud Formed
Public-Private Partnership to Prevent Health Care Fraud Announced by Health and Human Services

4. Improving Public Awareness and Reporting
The public sector can refine its "whistleblower" and awareness campaigns by studying what motivates individuals in the private sector to report fraud: 
The Public’s Self-Avoidance and Other-Reliance in the Reporting of Medical Insurance Fraud: A Cross-Sectional Survey in China

• Incentivizing Reporting: Research shows a "free-rider" mentality often prevents people from reporting public insurance fraud. Strengthening whistleblower protections and creating stronger incentives—similar to those in private litigation—can improve the flow of actionable leads to Medicaid Fraud Control Units (MFCUs).

Long-Standing State-Based Efforts to Combat Fraud Against Medicaid Continue to Improve

• Education on Specific Red Flags: Adopting private-sector training that teaches beneficiaries to look for "red flags" like pre-filled timesheets or inconsistent care plans can empower them as a front-line defense. 

Long-Term Care Fraud (NAIC)

Key Trend: Both sectors identify Personal Care Services (PCS) as the highest risk area. In Medicaid, PCS attendants and agencies accounted for the most fraud convictions (326 in FY 2025), a trend mirrored in private sector reports identifying home care as a "major industry challenge". 
Medicaid Fraud Control Units recover $700,000 in assisted living cases, with 300+ investigations still open
 

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Updated Monday, April 13, 2026, 10:03 AM (Pacific)
 
Seattle—

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LTC E-ALERT #26-011:  LTC NEWS AND COMMENT

LTC Comment:  Do you spend hours searching the internet for useful articles, key data, and relevant reports to keep you on the forefront of professional knowledge?  Do you lose business because you’re blindsided by clients or competitors who learn critical information before you do?  Here’s an antidote:

LTC Clippings:  The Center for Long-Term Care Reform notifies subscribers to our LTC Clippings service daily of information you need to know.  Each message contains only the critical facts about new publications:  a title, representative quote, a link to the original, and our analysis in a sentence or two.  To inquire or subscribe, contact Damon at 206-283-7036 or damon@centerltc.com.  Read testimonials by satisfied subscribers here.  To subscribe online, please click here.

LTC E-Alerts:  Once a week, we compile our daily LTC Clippings into a summary, email it to Center for Long-Term Care Reform members, and archive it in The Zone, our password-protected members-only website.  Center members also receive our weekly LTC Bullet op-ed.  To join the Center and receive all these benefits and more, contact Damon at 206-283-7036 or damon@centerltc.com.  

We no longer post our LTC E-Alerts on the Center’s public access website, but here’s what today’s LTC E-Alert contained:  links, quotes and comments on the following articles, reports, or data:

• Report: With spend-down of assets, US long-term care system ‘effectively penalizes aging’

• How Long-Term Care Costs Drain the Middle Class and Deepen Intergenerational Wealth Inequality

• Less than half of Americans are planning for their retirement healthcare needs, survey finds

• Skilled nursing emerging among most attractive real estate sectors

• Layin’ It on the Line: The long-term care crisis in Utah: Why national plans fail here and how to shield your assets (Part 2)

• Future long term care expenditure trajectories across OECD countries

• The Five Biggest Medicaid Planning Mistakes — and How to Avoid Them

• Rising Long-Term Healthcare Costs Pose Growing Threat to Farm Family Legacies

• Providers must educate prospects to cut gap between expectations, realities of senior living rates: report

• Eight arrested in $50M hospice fraud scheme as oversight intensifies

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"LTC E-Alerts" are a feature offered by the Center for Long-Term Care Reform, Inc. to members at the $150 per year level or higher.  We'll track and report to you news and analysis regarding long-term care financing, service delivery, and research.  We hope The LTC E-Alerts will help you attain and maintain a high level of knowledge and competency in this complex field.  The Center for Long-Term Care Reform, Inc. is a private institute dedicated to ensuring quality LTC for all Americans (www.centerltc.com).

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Updated Monday, April 6, 2026, 10:03 AM (Pacific)
 
Seattle—

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LTC E-ALERT #26-010:  LTC NEWS AND COMMENT

LTC Comment:  Do you spend hours searching the internet for useful articles, key data, and relevant reports to keep you on the forefront of professional knowledge?  Do you lose business because you’re blindsided by clients or competitors who learn critical information before you do?  Here’s an antidote:

LTC Clippings:  The Center for Long-Term Care Reform notifies subscribers to our LTC Clippings service daily of information you need to know.  Each message contains only the critical facts about new publications:  a title, representative quote, a link to the original, and our analysis in a sentence or two.  To inquire or subscribe, contact Damon at 206-283-7036 or damon@centerltc.com.  Read testimonials by satisfied subscribers here.  To subscribe online, please click here.

LTC E-Alerts:  Once a week, we compile our daily LTC Clippings into a summary, email it to Center for Long-Term Care Reform members, and archive it in The Zone, our password-protected members-only website.  Center members also receive our weekly LTC Bullet op-ed.  To join the Center and receive all these benefits and more, contact Damon at 206-283-7036 or damon@centerltc.com.  

We no longer post our LTC E-Alerts on the Center’s public access website, but here’s what today’s LTC E-Alert contained:  links, quotes and comments on the following articles, reports, or data:

• CMS CRUSH initiative alone not sufficient to fight fraud, groups say

• Federal Debt Management: Treasury Is Meeting Borrowing Needs but the Deteriorating Fiscal Outlook Poses Risks

• Home care groups CRUSH plans for more anti-fraud requirements

• What Happens When the Social Security Trust Fund Is Exhausted?

• Who should pay for older adults’ care? Caregivers answer differently

• Waste, Fraud, and Abuse in Government Health Care Programs is No Joke

• We Are 63 With $5.7 Million. My Wife Wants to Buy Long-Term Care Insurance, but I Want to Self-Insure. Who Is Right?

• New Medicare HCBS model, designed for California, targets ‘overlooked middle’

• Top economist finds silver lining for skilled nursing amid nation’s uncertain outlook

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"LTC E-Alerts" are a feature offered by the Center for Long-Term Care Reform, Inc. to members at the $150 per year level or higher.  We'll track and report to you news and analysis regarding long-term care financing, service delivery, and research.  We hope The LTC E-Alerts will help you attain and maintain a high level of knowledge and competency in this complex field.  The Center for Long-Term Care Reform, Inc. is a private institute dedicated to ensuring quality LTC for all Americans (www.centerltc.com).

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Updated Friday, April 3, 2026, 10:03 AM (Pacific)
 
Seattle—

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LTC Bullet: ILTCI 2026 Virtual Visit

LTC Comment: ILTCI ’26 was another successful industry convocation. This “virtual visit” to the conference is intended to give those who could not attend a sense of what it was like and to encourage them to consider attending in the future. It follows the ***news.***

*** HAPPY BIRTHDAY to the Center for Long-Term Care Reform. We completed our 28^th year on April 1, 2026. Check out the Center’s many state- and national-level policy studies here. Read dozens of published articles here. Speeches, here. Review hundreds of LTC Bullets, organized by topic and chronologically, here. This is how we announced our mission in “Center for Long-Term Care Financing Established; "LTC Bullets" Opening Salvo”: “The Center will advocate public policy that targets scarce public resources to the neediest, while encouraging people who are young, healthy and affluent enough, to take responsibility for themselves. We believe that private insurance and investment can guarantee quality long-term care for prosperous seniors and help to save the Medicaid long-term care program for the truly needy. The Center will offer a range of fee-for-service products to public and private clients including consulting, publishing, training and public speaking.” It’s been a great run and it will continue as long as we have your support and collegiality in our common mission to improve long-term care for all Americans. ***
 

LTC BULLET: ILTCI 2026 VIRTUAL VISIT

LTC Comment: The 2026 Intercompany Long-Term Care Insurance Conference convened March 8–11, 2026 in Orlando, FL at the Rosen Shingle Creek Resort. The meeting’s theme this year was "Dream… Design… Deliver: Reimagining the Future of LTC.” Conference chair, Gina Besz from “illumifin,” opened the proceedings. She told the 1000-plus attendees what to expect, thanked the organizers, presenters and sponsors, and disclosed (always a topic of great interest) the city hosting next year’s conference: Indianapolis, March 14-17, 2027. She also surprised us by sharing where the meeting will convene the following year: Houston, April 2-5, 2028.

Next came announcement of the ILTCI Recognition Award recipients for 2026. This award “honors the trailblazers, innovators, and lifelong contributors advancing long-term care insurance and shaping the future of aging in America.” Steve Serfass, Partner, Faegre Drinker Biddle and Reath, LLP, received the individual award. Two companies shared the organization award: Lincoln Financial and One America. Congratulations to these award recipients for their many years of dedication and hard work in our common mission to improve long-term care for all Americans.

Jeff Noel, a 30-year Disney Leadership veteran, sponsored by NGL, keynoted the conference. He's the author of “Mid-Life Celebration” and hosts the podcast “If Disney Ran Your Life.” Noel captivated the audience with stories and theories bearing on leadership excellence, employee engagement, customer service, brand loyalty, creativity and innovation. Always do “just a little more than what the customer expects.” Go the “extra inch” not just the last mile. Their standing ovation demonstrated the audience’s appreciation of his remarks.

The exhibit hall is a highlight of every ILTCI meeting. It is where attendees convene to eat, drink, visit exhibitors and network. I missed the opening exhibit hall reception Sunday night due to flight complications, but I attended the breakfast, lunch, and late-afternoon sessions on the remaining two days. To meet, greet, confer, pitch, negotiate and generally do business of any kind in the LTC insurance industry, there is nothing like the ILTCI conference with its exhibit hall and the ample opportunities to connect in the hallways as well. Be there next year in Indy if you can.

After Monday morning’s announcements and keynote address, the conference turned to breakout sessions. These included presentations on seven different subject tracks:

• Sales, Marketing, & Distribution: Focused on consumer engagement, expanding into middle-income markets, and distribution trends.
• Actuarial & Finance: Covered topics such as AI in actuarial work, asset-liability management, and in force management.
• Management & Operations: Addressed operational excellence, technology adoption, and call center evolution.
• Wellness & Aging in Place Solutions: Explored innovative services, technologies for aging in place, and AI/robotics in care.
• Claims & Underwriting: Focused on accelerated underwriting, electronic health records, and fraud detection.
• Legal, Compliance & Regulatory: Covered regulatory changes, compliance issues, and legal developments impacting LTC insurance.
• [Track Name Varies - General/Future Trends]: Covered broader industry topics, such as the future of LTC and caregiver crises. 

It seems like themes run through the ILTCI conferences for years at a time. I noted the focus on wellness in LTC Bullet: Virtual Visit to ILTCI 2023. Emphasizing wellness and doing more for policyholders than simply processing and paying claims remains a strong conference theme. But it seemed to me that at the 2026 program fraud identification, control, and mitigation took a new and bigger role. That topic especially interests me as fraud is soaring right now in public programs like Medicaid and Medicare. So you’ll see in what follows that I covered several breakout sessions aimed at the topic of fraud.

It’s worth noting that another theme, prominent in earlier ILTCI meetings, has disappeared. That is the public policy context in which the LTC insurance industry operates. Medicaid is the predominant payer for LTC in the USA. It crowds out private LTC insurance by desensitizing the public to LTC risk and cost leaving private LTC insurance with a small residual of the market. Yet Medicaid was barely mentioned at the 2026 conference. Even state experiments with public LTC financing such as WA Cares in Washington State and the latest proposal for a national LTC financing program, WISH, were mostly ignored. Of course, I wasn’t in every session, so maybe there was public policy content I missed, but with no track dedicated to the subject as in the past, its importance has clearly declined.

First Breakout Monday, March 9, 2026, 10:45am
Track: Legal, Compliance & Regulatory
Title: The Fraud Escape Room Experience: LTC Edition
Description: Step into the world of long-term care insurance fraud investigations—like you’ve never experienced before. This interactive session combines real-life case studies with an escape-room-inspired twist. Our expert panel will guide you through actual fraud investigations from across the country, highlighting the tactics and techniques used to uncover and stop bad actors. But beware: after each case, you’ll receive a cryptic clue left behind by a fictional mastermind who may be orchestrating these schemes. Are these cases truly unrelated, or is someone pulling the strings from the shadows? Work together to solve riddles, connect the dots, and uncover the truth before time runs out. Join us for a session that educates, entertains, and challenges your investigative instincts—because in this room, every detail matters.
Moderator:
Matt DeLong, illumifin
Presenters:
Tara Dickson, Cozen O'Conner
Adam Haque, John Hancock
Tom Kakos, illumifin
Matt Keeling, Unum
Comments: This program blew me away. I had no idea fraud was so rampant in private LTC insurance, nor did I know anything about the highly creative efforts carriers are employing to identify, prove, and control fraud that these speakers shared. They described three case studies, each of which was nearly beyond belief. They told of policy holders who claimed severe need, got approved, but were then shown to be fully capable of doing all the ADLs they claimed to be unable to manage. Arrogant and brazen, the fraudsters evaded being caught until they were shown to be out of compliance by clever methods described by these presenters. Such techniques included desktop investigation, searching social media, unmanned surveillance, tracking travel and many more.

Here’s just one of the anecdotes they shared. Married couple on claim since 2023. Both filed and approved for similar conditions. Tax qualified policies. Both had $380 per day home health unlimited lifetime. Both claimed they needed assistance with five out of six ADLs. Neither claimant had precipitating event. 12 hours a day 7 days a week for husband. 16 hours for wife. On claim same year. Documentation issues. Desktop investigation. Social media. Husband was sole owner of home care agency. Both reported not driving, using cane. Too consistent. Handwriting gave them away. The same individual did all the documentation. Extremely clever in how projected. Reviewers struck gold in social media, found something interesting. Extensive overseas trips while on claim, including Spain, Portugal, Puerto Rico, California. How could they do that while on claim? Are caregivers actually showing up? Got video taking trash out with no trouble, walking with no cane. Wife shopping loading, stuff in vehicle. All while claiming many hours of care. All activities while caregiver supposedly providing care. Did 15 days of surveillance. Never saw a single caregiver come. Interview. Time to talk to claimant. What did you do today, yesterday? Called and talked to husband. Insisted both need claims, can’t leave home without caregiver. Are caregivers present? Yes, but just stepped out to get lifesaving medications.

Showed him all documents, pressed further, eventually admitted he created all the documentation including the claims. Said took caregivers along on international trips. Should be records of this. Showed clips of him and wife moving independently. We’re always in pain, they said. Where are your caregivers? Biggest turn of investigation. Caregivers returned from errands. Did not see anyone from our surveillance. No photo IDs. Husband answered all their questions. Week later, called husband back. He admitted in Philippines. Who were those individuals claimed to be caregivers? Just locals from Philippines. Case outcomes. Both claims reviewed by medical staff. Claims closed. Fraud, waste and abuse reported to Dept. of Insurance. Settlement reached. Surrendered both policies and made some repayment.  

Second Breakout, Monday, March 9, 2026, 2pm
Track: Legal, Compliance, & Regulatory
Title: Inside the Jury Box: An LTCI Mock Voir Dire, How Everyday Consumers View LTC Insurance
Description: What do everyday consumers really think about long-term care insurance—and how might those views shape the outcome of a trial? In this interactive session, we’ll stage a mock voir dire (jury selection) to explore how potential jurors respond to key concepts like policy language, benefit triggers, and product design. Participants will observe and engage with the process as attorneys question mock jurors, uncover biases, and strategize selections. Beyond the courtroom drama, this session offers a rare opportunity to hear unfiltered consumer attitudes toward LTC insurers, coverage expectations, and claims disputes. Whether you're in legal, compliance, product, or risk, you'll walk away with a deeper understanding of how your decisions may be interpreted by a jury—and how to prepare for it.
Moderator:
Gina Fortin, Unum
Presenters:
Matt Kops, Blueprint Trial Consulting
Chris Petillo, Faegre Drinker
Michael Rafalko, Cozen O'Connor
Comments: Clever idea. Attorneys for the plaintiff and the defendant interviewed “jurors” playing various roles to represent different kinds of consumers. Jurors bring experiences, attitudes/values and personalities to court. A “jury consultant” commented on the process of selecting or rejecting jurors in the voir dire process of a trial. All 9 jurors interviewed by both attorneys based on a hypothetical complaint fact pattern. Each attorney eliminated three jurors based on brief 4-minute interviews leaving three of the nine empaneled. The session used audience polling. The idea was to tease out consumer attitudes about LTC insurance, but the jurors were all people in the business. So I’m not sure that objective was achieved. But the session definitely invited consideration of complex ideas and attitudes about the product.

Third Breakout, Monday, March 9, 2026, 3:45pm
Track: Wellness & Aging in Place Solutions
Title: Imagineering Aging with a Gen Z Advocate: Promising Models and Interrogational Collaboration
Description: In this fireside chat led by Gen Z advocate Arielle Galinsky, we'll explore bold ideas for aging-in-place, LTC policy reform, and the importance of multigenerational collaboration. Arielle brings her deep passion on all things aging & LTC as well as her commitment to advancing aging policy reform at the state and national levels. From her research and experience, she will lead insightful conversation on 1) why aging needs to be an intergenerational conversation, 2) what we can learn from international aging models and policies, 3) and what policymakers need to know to make this vision a reality. Get ready for an energizing conversation that brings a fresh, forward-thinking perspective on aging.
Speakers:
Cailyn Canty, Davies
Arielle Galinsky, The Legacy Project, Inc.
Comments:
This session was intended to bring to light the innovative perspectives of a Gen Z influencer. The principle speaker, Ms. Galinsky, was articulate and knowledgeable. Her views were grounded in personal experience. She became a Certified Nursing Assistant (CNA) to understand better the challenges of caregiving. Very thoughtful, but I discerned little unique perspective from the younger generation. She seemed to be saying what older generations are also saying with little new analysis. A promising wrap up to the conversation was promised. But it amounted to referencing states that have proposed new policy models like WA Cares. What is one thing we can all do? Support the WISH Act; advocate for it. This is not fresh thinking, only restating the current public policy thinking, such as it is in the LTC insurance business.

2^nd day March 10, 2026, 9am
Track: Claims and Underwriting
Title: The Current Anti-Fraud Landscape: Industry Insights
Description: Join leading experts as they share how carriers are currently viewing and addressing fraud. This session will dive into the latest industry survey findings, examine innovative approaches to fraud mitigation, and explore effective models for managing fraud, waste, and abuse (FWA). Attendees will gain valuable perspectives on current challenges and best practices to safeguard the integrity of LTC claims.
Moderator:
Roy Christenson, ERAC
Speakers:
Jeff Ferrand, illumifin
Jessica Loesing Gallagher, Faegre Drinker
Tom McManama, PwC
Comments: Fascinating session. Fraud recognized as a problem 20 years ago, but over the past 10 years it has really taken off. No longer lost in a claims “black box.” Fraud identification and control is getting more sophisticated. Rapid acceleration of technology. Trying to leverage it. Fraud thought to affect other business lines, but now seen to hit LTC insurance too. PwC Anti-Fraud Survey showed 6 to 8% of claims have fraud. $1.3 billion. By 2030 Milliman found $25 billion claims in four years. So $2.5 to $3 billion in fraud. “We are all fraud ambassadors now.” Much higher for home health care than these estimates that are across all products. What is most common type? Claimant and provider fraud and combination, collusion. Not eligible at start or became not eligible but stayed on claim. Provider bills where not providing care. Skimming. Charge for more and pocket some. Easier to investigate home health care (HHC) so tend to start there. Facility fraud has lot of checks and balances. Vulnerability in billing practices. Little prosecution of fraud. Prosecutors focus on bigger fish, like Medicare and Medicaid. The Centers for Medicare and Medicaid Services (CMS) are only now beginning to search for and control fraud that runs rampant in public programs but receives little attention from states that reap a bonanza of federal funding.

2^nd day March 10, 2026, 10:45pm
Track: Management & Operations
Title: AI Fakes and Real Risks: Securing Long-Term Care Systems from Manipulation
Description: As deep fake technology becomes more sophisticated, the long-term care industry faces new threats to operational integrity and patient safety. This session explores how AI-generated falsifications can impact critical areas such as HR, policy administration, and claims —posing risks to claims processing and regulatory compliance. We’ll examine real-world scenarios, discuss detection strategies, and explore how organizations can safeguard against manipulation while maintaining trust and accuracy in their data systems.
Producer (non-participant):
Paul Marquez, Diligence International Group, LLC
Speakers:
Karen Babio, Davies
Kevin Glasgow, Diligence International Group
Comments:
Overview: Fakes not new, old theme, me toos, art of deception. AI to create fakes, creating synthetic identities, tech and tools; is your insurer ready? Most people are honest but some aren’t. Out there to defraud in any way they can. Have to be careful because there are bad actors. What is a deep fake? Universal studios pioneered computer generated voice or image to look real. Systems learn from each other improving deep fakes. Trojan horse. New tools lowered cost and skill needed. Art of deception: cognitive biases, shortcuts, emotional influence, social trust, cooperation, cognitive overload tendencies for over confidence, expertise gaps. They only have to be right a small percent of time. Criminals targeting. Awareness gap. Tech gap. What’s changed? Presenters created the introductory fake very easy, low level. No tech training. Very low cost to create avatar. Could have done anyone in the room.
“Catch me if you can”: movie. Impersonations. Major insight: Change in attitude toward nonviolent crime. Younger generation much more accepting of profiting from nonviolent crime. Consider in context of home health fraud. Effect on jury pools.
Fakes are nothing new. Just new tech doing more things. Voting on which images real. About random chance. Better at finding video fakes.
Using AI fakes to make better, smarter, faster. Phishing, spear phishing (targeted), vishing (video phishing), smishing (using fraudulent texts). Counterfeit compliance certs insurance certificates.
Financial records, invoices paystubs, utility bills tax form, fake ID documents.
Possible imposter originated scams initiators and facilitators: family members, people in position of trust, insurance community members, human traffickers, organized crime groups, paramedical examiners, attorneys, brokers, investors. Getting more organized.
Has your organization any training for deep fakes? What kind?
Apply for credit over and over again. Loyalty information. Gradually create identify. Get higher and higher credit rating. Fictitious person. Continue to “ripen” ID until accepted.
AI fraud surges 195%. AI arms race. Synthetic identities. $30 billion in life insurance industry annually.
Companies need to think more like banks.
Threat actors always out there. Attitude shapes moral compass against insurers. Insurance has a high ROI. Organized crime funding has entered the fray.
SIFT: Stop, investigate, find, trace to original source. 

2^nd day March 10, 2026, 2pm
Track: Management & Operations
Title: Inside the Mind of a Hacker: Cyber security Threats and Defenses in Insurance
Description: Join an ethical hacker for a behind-the-scenes look at how cybercriminals are evolving - and how AI is reshaping the cyber security landscape. Through real-world examples and expert insights, this session reveals common vulnerabilities, emerging AI-driven attack methods, and practical defenses. Learn how cyber security impacts your business - and walk away with actionable strategies to protect your organization from the risks of an AI-enabled threat environment.
Moderator: Christie Conway, Wellcove
Speakers:
Kalin Kelly, Continental General
Tom Liston, Bad Wolf Security
Comments: AI is not experimental, it’s in the wild. Changing rules for defenders and offenders. What is AI? Systems that find patterns, massive data sets, on internet. Lots of knowledge. But dark side. Models mimic understanding brilliantly. But they don’t reason. Excel at static prediction not logical deduction. Content generation, code assistance, customer service, and everything else. Private investment in generative AI soaring. $34 billion, up 19%. Limits of today’s AI, not necessarily going to get same output every time. May confidently present but it is wrong. Not responsible for anything. Falls on humans to control. 4.4% 2023 performance 71.7% 2024 performance. AI coding capability has gone explosive in growth. Hackers faster, defenders smarter. Fraud pattern detection. Synthetic employees, when agents talk to agents. Undercurrent. Sub layer underneath humans. Unmonitored. Could proliferate bad information. Driven social engineering. Excellent impersonalization. Video calls. Texts. Email. Phone. Fake documents. Executive impersonalization. Uncomfortable truth. What companies doing. Not a lot. 78% use, 40% mitigate risk, 37% have governance. Adoption has exploded, but governance last.
97% no access controls, 63% no governance. Average global breach cost: $4.4 million.

Tom Liston: I’m a thief. Broke into banks and much else. 60% of firms suffered data breach; 277 days to discover a data breach; Overall 93% resulted in an external attacker gaining internal network access. He set out to find one compromised business per day. Found 500. Very easy. Who? Small to medium business, large well-known companies, government organizations; universities. Solutions: Treat network as if it is compromised; Limit damage attacker can do, network security basics not magic black box. Use multi-factor identification. Monitor closely.

2^nd day March 10, 2026, 3:45pm
Track: Claims & Underwriting
Title: Game On: Integrating FWA Programs into the Claims Process - A Chutes and Ladders Experience
Description: Join us for an engaging and interactive session that brings the classic board game Chutes and Ladders to life. This dynamic experience combines audience participation with practical insights, guiding you through the highs and lows of integrating FWA programs into the LTC claim process. Each “move” on the board represents real-world examples, challenges, and opportunities - including emerging technologies, digital controls, smart workflows, and human insights. Led by seasoned claims executives and an experienced trial attorney, this session goes beyond theory—offering actionable strategies, risk mitigation tips, and legal perspectives that matter. Whether you climb the ladder of success or slide down a chute of unexpected complications, you’ll leave with a deeper understanding of how to stay ahead in today’s evolving long-term care claims landscape.
Moderator:
Jane Bagley, Fuzion
Speakers:      
Andrew Azarmi, Dentons
Laurene Polignone, John Hancock Financial Services
Kristen Sewell, Continental General
Comments:
Series of scenarios offered. Then vote on whether fraud or not. Go down a chute if wrong; up a ladder if correct. In the middle, I noted “So far all examples obvious.” Andrew, the attorney, comes at it from a different perspective. Lawyer, not insurance company. Lessons learned. Facts in claims can become questionable. Policyholder appeals claim denial. Submits signed letter from primary care physician Dr. Feelgood. Under his care. Suffers cognitive impairment. Needs assistance with several ADLs .You verify Dr. Feelgood is a board certified MD. Video surveillance over 5 days reveals policyholder is walking, driving, entering/exiting sedan, rolling 2 large trash cans from curb up sloped driveway into garage. Picking up dry cleaning while talking on cell. Entering and exiting Pilates studio. Answer: Time review. 

3^rd Day, March 11, 2026, 8:30am
Title: Alzheimer's Association: Explore Cutting-edge Developments in Brain Health, Diagnosis, and Treatments
Description: Learn how lifestyle interventions can reduce the risk of cognitive impairment, how blood-based biomarkers are enabling earlier, more accessible Alzheimer’s diagnosis and advancements in treatments. The second half of this session will provide a comprehensive overview of rapidly moving innovations within dementia care specialty models including both Medicare and Medicare Advantage funded approaches. The impressive early clinical and cost savings outcomes and how LTCI specifically might take advantage in the short-to-mid-term. Discussions will include an overview of the Dementia Care Navigation Service, powered by Rippl and the Alzheimer’s Association, which has shown promising results including a 30% drop in emergency department visits and a 15% reduction in hospital admissions through personalized, proactive support aligned with Center for Medicare and Medicaid’s GUIDE Model.

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Updated Monday, March 30, 2026, 10:03 AM (Pacific)
 
Seattle—

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LTC E-ALERT #26-009:  LTC NEWS AND COMMENT

LTC Comment:  Do you spend hours searching the internet for useful articles, key data, and relevant reports to keep you on the forefront of professional knowledge?  Do you lose business because you’re blindsided by clients or competitors who learn critical information before you do?  Here’s an antidote:

LTC Clippings:  The Center for Long-Term Care Reform notifies subscribers to our LTC Clippings service daily of information you need to know.  Each message contains only the critical facts about new publications:  a title, representative quote, a link to the original, and our analysis in a sentence or two.  To inquire or subscribe, contact Damon at 206-283-7036 or damon@centerltc.com.  Read testimonials by satisfied subscribers here.  To subscribe online, please click here.

LTC E-Alerts:  Once a week, we compile our daily LTC Clippings into a summary, email it to Center for Long-Term Care Reform members, and archive it in The Zone, our password-protected members-only website.  Center members also receive our weekly LTC Bullet op-ed.  To join the Center and receive all these benefits and more, contact Damon at 206-283-7036 or damon@centerltc.com.  

We no longer post our LTC E-Alerts on the Center’s public access website, but here’s what today’s LTC E-Alert contained:  links, quotes and comments on the following articles, reports, or data:

• My brother says lawyers can get him a Medicaid nursing home in Florida for a ‘hefty fee,’ despite his assets. Is this a scam?

• Family caregivers’ unpaid work valued at over $1T in 2024, AARP report finds

• China launches long-term care insurance system to alleviate aging challenges

• Long-term care is expensive. Take these 3 steps now to help you afford it later.

• Fears Over Retirement Healthcare Costs Are Rising — And Many Americans Aren’t Planning for Them

• A Medicaid 'spend down' may get an older person long-term care coverage but isn't a DIY strategy

• 5 ‘AI-proof’ healthcare jobs will surge through 2034

• Lincoln Financial Recognized for Leadership in the Advancement of Long-Term Care Planning

• Japan's elder-to-elder caregiving crisis fuels homicides and hidden neglect

• ‘Heartbreaking and destructive’: Ohio lawmakers seek to rein in Medicaid home liens

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"LTC E-Alerts" are a feature offered by the Center for Long-Term Care Reform, Inc. to members at the $150 per year level or higher.  We'll track and report to you news and analysis regarding long-term care financing, service delivery, and research.  We hope The LTC E-Alerts will help you attain and maintain a high level of knowledge and competency in this complex field.  The Center for Long-Term Care Reform, Inc. is a private institute dedicated to ensuring quality LTC for all Americans (www.centerltc.com).

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Updated Wednesday, March 25, 2026, 10:03 AM (Pacific)
 
Seattle—

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LTC E-ALERT #26-008:  LTC NEWS AND COMMENT

LTC Comment:  Do you spend hours searching the internet for useful articles, key data, and relevant reports to keep you on the forefront of professional knowledge?  Do you lose business because you’re blindsided by clients or competitors who learn critical information before you do?  Here’s an antidote:

LTC Clippings:  The Center for Long-Term Care Reform notifies subscribers to our LTC Clippings service daily of information you need to know.  Each message contains only the critical facts about new publications:  a title, representative quote, a link to the original, and our analysis in a sentence or two.  To inquire or subscribe, contact Damon at 206-283-7036 or damon@centerltc.com.  Read testimonials by satisfied subscribers here.  To subscribe online, please click here.

LTC E-Alerts:  Once a week, we compile our daily LTC Clippings into a summary, email it to Center for Long-Term Care Reform members, and archive it in The Zone, our password-protected members-only website.  Center members also receive our weekly LTC Bullet op-ed.  To join the Center and receive all these benefits and more, contact Damon at 206-283-7036 or damon@centerltc.com.  

We no longer post our LTC E-Alerts on the Center’s public access website, but here’s what today’s LTC E-Alert contained:  links, quotes and comments on the following articles, reports, or data:

• Senior care rates balloon in every state: CareScout report

• Older adults with financial trouble experience faster cognitive decline, study finds

• CMS’ anti-fraud tactics run risk of destabilizing HCBS system, article asserts

• Alzheimer’s beneficiaries benefited from Medicare Advantage risk adjustment model, study finds

• Lawmakers reintroduce Hospice CARE Act, which would update benefit, help stop fraud

• UPDATED: ‘Good news’ as CMS doubles spending on nursing home staffing campaign

• 2026 Long-Term Care Market Outlook

• Simultaneous senior care and child care burdening ‘sandwich generation,’ report finds

• State scraps managed care for Medicaid’s LTC patients

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"LTC E-Alerts" are a feature offered by the Center for Long-Term Care Reform, Inc. to members at the $150 per year level or higher.  We'll track and report to you news and analysis regarding long-term care financing, service delivery, and research.  We hope The LTC E-Alerts will help you attain and maintain a high level of knowledge and competency in this complex field.  The Center for Long-Term Care Reform, Inc. is a private institute dedicated to ensuring quality LTC for all Americans (www.centerltc.com).

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Updated Monday, March 23, 2026, 10:03 AM (Pacific)
 
Seattle—

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