County: Wood
Age: 87
Our client contacted us after she received a statement in the mail from Capital One with charges for privacy protection. She recalls having been solicited by Capital One via telephone. My client is elderly and hard of hearing. She never wanted the card, but she was signed up anyway with privacy protection after the initial solicitation. I sent a letter disputing the charges and requesting her account be closed since she never authorized the card in the first place. My client received confirmation that her balance with Capital One is now zero and the account has been closed.
Monday, March 20, 2006
Monday, March 13, 2006
Case of the Week: 3/10/06
County: Taylor
Age: 74
Our client received a letter from a collector regarding her student loan from 20 years ago. My client had limited information regarding the loan. I contacted the collection company and learned that the loan is federally insured. I explained to our client that although her Social Security benefits may be garnished, she can exempt up to $750 per month from garnishment. Since my client receives $700 per month, she can exempt the entire amount.
Age: 74
Our client received a letter from a collector regarding her student loan from 20 years ago. My client had limited information regarding the loan. I contacted the collection company and learned that the loan is federally insured. I explained to our client that although her Social Security benefits may be garnished, she can exempt up to $750 per month from garnishment. Since my client receives $700 per month, she can exempt the entire amount.
Tuesday, February 28, 2006
Case of the Week: 3/3/06
County: Wayne
Age: 71
This client contacted us after receiving a hospital bill in the amount of $3000 for services that should have been covered under his Medicare Part B. I contacted the billing office of the hospital and explained that my client is covered under Medicare Part B and, therefore, the hospital must file a claim through Medicare. After gathering my client's Medicare information the hospital filed its claim. Medicare covered most of the balance. My client can be billed for only $450 for co-pays and deductibles.
Age: 71
This client contacted us after receiving a hospital bill in the amount of $3000 for services that should have been covered under his Medicare Part B. I contacted the billing office of the hospital and explained that my client is covered under Medicare Part B and, therefore, the hospital must file a claim through Medicare. After gathering my client's Medicare information the hospital filed its claim. Medicare covered most of the balance. My client can be billed for only $450 for co-pays and deductibles.
Monday, February 27, 2006
Changes in Aged and Disabled Waiver getting plenty of press
West Virginia Public Radio broadcast a 3 part series on West Virginia Morning about changes in the medical assessment and reassessment for the Aged and Disabled Medicaid Waiver program (ADW). Kate Long interviewed waiver beneficiaries, waiver service providers, administrators, and advocates, including your truly. Her story focused on the tragic human impact of the recent changes that have made the program harder to get on and stay on. Kate's piece delved into the changes brought about by the new PAS 2005's stricter criteria as well as the state contracting with WVMI to complete PAS's. She also highlighted several elderly individuals who have suffered because of these changes.
In yesterday's Sunday Gazette-Mail there was an excellent article by Scott Finn in the same vein. Scott's piece focuses on the stories of a few waiver clients who are very sick, and yet are being taken off the program.
This waiver has been underfunded for at least the 10 years I've been working with these clients. It still is, and now that there is a large national movement to reduce the costs of Medicaid, I'm afraid the very needy people who benefit from this waiver are among the targeted.
Tuesday, February 21, 2006
Case of the Weekd: 2/17/05
County: Jefferson
Age: 65
This client contacted us after her received a notice to garnish his Social Security for child support. The original order was issued 30 years ago in another state. He also informed me that up until three years ago his taxes were being off-set to pay for the past due support. After reviewing his notice and the law, I was able to advise him that although Social Secuirty benefits can be garnished for support orders, West Virginia law provides a 10 years statute of limitations on judgements. Moreover, the statute of limitations is not tolled by tax offsets or moving to a different jurisdiction. My client can protect his benefit .
Age: 65
This client contacted us after her received a notice to garnish his Social Security for child support. The original order was issued 30 years ago in another state. He also informed me that up until three years ago his taxes were being off-set to pay for the past due support. After reviewing his notice and the law, I was able to advise him that although Social Secuirty benefits can be garnished for support orders, West Virginia law provides a 10 years statute of limitations on judgements. Moreover, the statute of limitations is not tolled by tax offsets or moving to a different jurisdiction. My client can protect his benefit .
Thursday, February 09, 2006
WVA legal director position vacant; WVA now handling ADW appeals
I recently learned that Tom Gillooly is no longer the legal director for The West Virginia Advocates (WVA), the federally designated protection and advocacy provider for West Virginians with disabilities. The organization is accepting applications through March 1, 2006, and the position was advertised in the Sunday Gazette-Mail this week.
Clarice Hausch, the Executive Director, would not go into detail about why Tom was no longer with the organization, but she did tell me that he did some great work for them during his tenure at WVA.
And good news for folks whose medical eligibility is being denied or reduced for Aged and Disabled Waiver (ADW) services, Clarice said WVA is looking to take some of those cases for legal representation. Particularly, she explained, their funding streams which support assisting people with physical disabilities and/or some mental illness are not yet exhausted.
Legal Aid of West Virginia has been handling many ADW appeals, so hopefully these two entities will coordinate and collaborate to efficiently get the best representation possible for these important cases. As soon as I know more details about who is taking which kinds of cases, I will post them here, so we can all make good referrals.
Clarice Hausch, the Executive Director, would not go into detail about why Tom was no longer with the organization, but she did tell me that he did some great work for them during his tenure at WVA.
And good news for folks whose medical eligibility is being denied or reduced for Aged and Disabled Waiver (ADW) services, Clarice said WVA is looking to take some of those cases for legal representation. Particularly, she explained, their funding streams which support assisting people with physical disabilities and/or some mental illness are not yet exhausted.
Legal Aid of West Virginia has been handling many ADW appeals, so hopefully these two entities will coordinate and collaborate to efficiently get the best representation possible for these important cases. As soon as I know more details about who is taking which kinds of cases, I will post them here, so we can all make good referrals.
Tuesday, February 07, 2006
Case of the Week: 2/10/06
County: Mon
Age: 67
Our client contacted us because he was in an auto accident. Because he did not have insurance, he was being pursued by the other motorist's insurance company. Our client also has an 80 percent loss of hearing that made it very difficult for him to work anything out with the company. I contacted the company on his behalf and negotiated a settlement which saved my client $704 off the origianl claim.
Age: 67
Our client contacted us because he was in an auto accident. Because he did not have insurance, he was being pursued by the other motorist's insurance company. Our client also has an 80 percent loss of hearing that made it very difficult for him to work anything out with the company. I contacted the company on his behalf and negotiated a settlement which saved my client $704 off the origianl claim.
Case of the Week: 2/3/06
County: Berkeley
Age: 71
This client contacted us because his apartment complex is getting foreclosed upon. Because his rent was subsidized, he would face an increase in rent once the sale was final. To avoid this, he found another, affordable place to live. Given that his is a month to month tenant, generally he would have to give 30 days notice before terminating the tenancy, but given the seriousness of this situation, my client wanted to move right away. I contacted the manager and explained the client's situation and she agreed to waive the 30 day notice and also agreed to return my client's security deposit.
Age: 71
This client contacted us because his apartment complex is getting foreclosed upon. Because his rent was subsidized, he would face an increase in rent once the sale was final. To avoid this, he found another, affordable place to live. Given that his is a month to month tenant, generally he would have to give 30 days notice before terminating the tenancy, but given the seriousness of this situation, my client wanted to move right away. I contacted the manager and explained the client's situation and she agreed to waive the 30 day notice and also agreed to return my client's security deposit.
Monday, January 23, 2006
First look at 2006 WV Legislation and seniors; and it's not "HIPPA," it's "HIPAA"
And back to things that really matter, our state legislature is now in its annual 2 month regular session. The state Bureau of Senior Services kindly publishes a weekly legislative roundup of the status of bills affecting seniors. From that large list I cooked down a few to keep an eye on:
Many about healthcare, including:
- requiring itemized statements of services billed for Medicaid recipients (SB 79, HB 2318)
- a good samaritan-type law waiving liability for physicians providing services to indigent people (SB 82)
- requiring health insurance policies to cover acupuncture (SB 104. 190)
- creating an Alzheimer's Caregiver Assistance Program (SB 109) and establishing an Alzheimer's Disease Registry (SB 112)
- authorizing dispensing and delivery of drugs to remote health clinics (SB 143)
- establishing the WV Fair Share Health Care Act allowing the state to offset healthcare costs from large employers who spend too little on employee health bene's (SB 147)
- permitting physicians to issue "do not resuscitate" orders on patients who lack healthcare decisionmaking capacity and for whom CPR would not be effective (SB 161, HB 4022)
- exempting from the Medicaid preferred drug list certain anti-psychotic drugs for certain high-risk patients (HB 2406)
- making in-home care available on a sliding fee scale for seniors age 65+ (HB 2324)
- requiring Alzheimer's training for certain personnel of longterm care facilities and adult day care facilities (HB 2649)
- establishes information sharing between pharmacies to prevent multiple prescriptions abuse (HB 2768)
- prohibiting pharmacists from refusing to fill prescriptions without valid reason (HB 2807)
- creates voluntary state income tax check-off to develop pharmaceutical assistance program for WV seniors (HB 3265)
- adds "nursing homes" to the list of facilities whose certain unlicensed staff are authorized to administer drug (HB 2138)
- permits electronic monitoring of nursing home residents by themselves or their representatives (HB 2272)
- creates quality assurance program for nursing homes (HB 2281)
- requiring specific staffing levels in nursing homes and providing penalties for non-compliance (HB 2360)
- creating a physician's lien on injury awards and settlements (SB 48)
- creating an Insurance Advocacy Unit within the state Attorney General's Office (SB 140)
- requiring consumer notification of negative credit ratings (SB 185)
- eliminating the 90-day mandatory reinstatement of lapsed auto insurance policies (SB 198)
- prohibiting non-renewal of auto and property insuance policies (SB 203)
- exempting seniors age 65+ from having to pay the fees associated with redemption of property from tax sale within 2 years (HB 2097)
- requiring hospitals to disclose their infection rates (HB 2180)
- making the senior discount at campgrounds and parks year-round (HB 2300)
- requiring grab bars to be installed in all hotel and motel baths and showers (HB 2312)
- reducing the statute of limitation on consumers filing actions regarding revolving credit against creditors pursuant to the Consumer Protection Act (CPA) from 4 years to 1 year (HB 3113)
- eliminating the probate of uncontested small estates (HB 3221)
- increasing the amount of the homestead tax exemption from $20,000 to $50,000 (HJR 1) or from $20,000 to $40,000 (HJR 06, and 19)
- requiring Adult Protective Services to complete a face-to-face interview with an adult reported to be abused or neglected within 14 days of the report, and within 72 hours if imminent danger or serious physical abuse is alleged in the report (HB 2048)
- adding identity theft to the list of crimes for which victims can get victims compensation funds awarded (HB 2049)
- creating a program to reprogram and distribute (HB 2067, 2842)
And this is just the beginning of the session, so there will likely be more bills affecting seniors in the next weeks.
Tuesday, January 17, 2006
Case of the Week: 1/9/06
County: Grant
Age: 64
This client contacted us because his administrative hearing with the Department of Motor Vehicles has been postponed. Our client was pulled over for drinking and driving. His attorney was able to get a favorable outcome in the criminal case since our client was not under the influence of alcohol; however, his administrative case to determine wether his driving privileges should be suspended has not happened yet because the arresting officer is currently serving in Iraq. Our client wanted to know his due process and administrative due process rights. I researched the issue for him and explained that although the WV Supreme Court has stated a driver's license is a property interest within the protection of the WV Due Process Clause, the commissioner under the Code of State Rules may postpone a hearing upon his own motion for good cause. Since the arresting officer, who is crucial to the hearing, will not be available, then the commission has the authority to postpone. Also, since our client still has his driving privileges, he is not being harmed by the delay. Our client is low income and the research we provided is quite valuable to him as it would have cost quite a bit to have a private attorney do the same research.
Age: 64
This client contacted us because his administrative hearing with the Department of Motor Vehicles has been postponed. Our client was pulled over for drinking and driving. His attorney was able to get a favorable outcome in the criminal case since our client was not under the influence of alcohol; however, his administrative case to determine wether his driving privileges should be suspended has not happened yet because the arresting officer is currently serving in Iraq. Our client wanted to know his due process and administrative due process rights. I researched the issue for him and explained that although the WV Supreme Court has stated a driver's license is a property interest within the protection of the WV Due Process Clause, the commissioner under the Code of State Rules may postpone a hearing upon his own motion for good cause. Since the arresting officer, who is crucial to the hearing, will not be available, then the commission has the authority to postpone. Also, since our client still has his driving privileges, he is not being harmed by the delay. Our client is low income and the research we provided is quite valuable to him as it would have cost quite a bit to have a private attorney do the same research.
Thursday, January 12, 2006
Coal Company Retirees, M'care Part D, UMWA update
This is a followup to my post last week in this blog about coal retirees getting threatened with losing their company healthcare benefits if they didn't enroll in a Medicare Part D plan by December 31, 2005.
According to Brian Sampson in the President's office at the United Mine Workers Union (UMWA), all the coal companies the UMWA deals with nationwide took the 28% government incentive to keep all their current retiree drug benefits in place except these four: Peabody, Consol, Arch, and Bluestone. These four companies instead demanded each of their retirees (and their dependants) enroll in a Part D plan or lose all retiree health coverage by December 31, 2005.
UMWA quickly went into negotiations with these four companies to advocate the position that the collective bargaining agreements in place guaranteed these retirees their existing benefits, and they could not be forced to enroll in a Part D plan to keep what they already had a right to. UMWA, however, did send letters to their member retirees recommending that they go ahead and enroll while the union continued to dispute the actions of the companies.
According to a press release from UMWA issued December 29, 2005, the companies have all agreed not to take away the health benefits of those who have not enrolled in drug plans while the dispute is resolved. According to Brian, all four companies have also agreed that they will provide wraparound coverage at the levels they provided before. This means that retirees would not have to pay any more out of pocket than they did before. Hopefully they would each have two prescription cards, one from the Part D provider they chose, and one from the company's provider which would cover deductibles and copays beyond the out-of-pocket limits they had before. If the companies require burdensome paperwork or other hoops for retirees to jump through to get the wraparound coverage, this will be an important issue for advocacy.
Also according to Brian all sides have agreed to expedite the issue, and if they cannot come to an agreement it will go through the Resolution of Dispute (ROD) process of collective bargaining, to be decided by a board of trustees. If the UMWA is not satisfied with that decision, they may take it to the next level which is arbitration. Brian expects that the resolution will be final before May 15, 2006, since all sides know that the federal legislation creating Part D imposes penalties on current beneficiaries who enroll after that date.
So at this point we at WVSLA agree that it is probably best for these retirees who have not yet enrolled to go ahead and do so. Humana is the company with the lowest premiums in West Virginia, and though UMWA does not endorse the company, they suggest their members who haven't chosen yet to consider enrolling in Humana to at least get enrolled in something. If the companies do provide wraparound coverage it won't much matter what the Part D plan covers since the companies will make up the difference, so low premiums will suit most retirees best.
Because of the agreements reached so far, retirees should not be experiencing coverage lapses. Consol retirees who are having problems with coverage at the pharmacy can contact Consol's retiree call center at 1-877-240-0139. Retirees from Peabody, Arch, and Bluestone who are experiencing coverage problems can contact the union at (304) 346-0342.
According to Brian Sampson in the President's office at the United Mine Workers Union (UMWA), all the coal companies the UMWA deals with nationwide took the 28% government incentive to keep all their current retiree drug benefits in place except these four: Peabody, Consol, Arch, and Bluestone. These four companies instead demanded each of their retirees (and their dependants) enroll in a Part D plan or lose all retiree health coverage by December 31, 2005.
UMWA quickly went into negotiations with these four companies to advocate the position that the collective bargaining agreements in place guaranteed these retirees their existing benefits, and they could not be forced to enroll in a Part D plan to keep what they already had a right to. UMWA, however, did send letters to their member retirees recommending that they go ahead and enroll while the union continued to dispute the actions of the companies.
According to a press release from UMWA issued December 29, 2005, the companies have all agreed not to take away the health benefits of those who have not enrolled in drug plans while the dispute is resolved. According to Brian, all four companies have also agreed that they will provide wraparound coverage at the levels they provided before. This means that retirees would not have to pay any more out of pocket than they did before. Hopefully they would each have two prescription cards, one from the Part D provider they chose, and one from the company's provider which would cover deductibles and copays beyond the out-of-pocket limits they had before. If the companies require burdensome paperwork or other hoops for retirees to jump through to get the wraparound coverage, this will be an important issue for advocacy.
Also according to Brian all sides have agreed to expedite the issue, and if they cannot come to an agreement it will go through the Resolution of Dispute (ROD) process of collective bargaining, to be decided by a board of trustees. If the UMWA is not satisfied with that decision, they may take it to the next level which is arbitration. Brian expects that the resolution will be final before May 15, 2006, since all sides know that the federal legislation creating Part D imposes penalties on current beneficiaries who enroll after that date.
So at this point we at WVSLA agree that it is probably best for these retirees who have not yet enrolled to go ahead and do so. Humana is the company with the lowest premiums in West Virginia, and though UMWA does not endorse the company, they suggest their members who haven't chosen yet to consider enrolling in Humana to at least get enrolled in something. If the companies do provide wraparound coverage it won't much matter what the Part D plan covers since the companies will make up the difference, so low premiums will suit most retirees best.
Because of the agreements reached so far, retirees should not be experiencing coverage lapses. Consol retirees who are having problems with coverage at the pharmacy can contact Consol's retiree call center at 1-877-240-0139. Retirees from Peabody, Arch, and Bluestone who are experiencing coverage problems can contact the union at (304) 346-0342.
Tuesday, January 03, 2006
Coal Company Retirees and Medicare Prescription Drug Plan Enrollment
Just before the end of 2005 a panic developed among many Medicare-eligible coal company retirees. They got letters saying that they (and their spouses and dependents) would lose all their retiree healthcare benefits if they did not enroll in a Medicare prescription drug plan by December 31, 2005. These retirees have typically had excellent healthcare coverage, including some of the best prescription drug coverage of any retirement plans available in West Virginia. Some have paid no more than $50 out of pocket per year for drugs, even if they got thousands of dollars worth of prescriptions each year.
What about those retirees who are very sick and whose lives depend on costly medical care? What about those retirees who couldn't read or understand their letter (perhaps because of illiteracy, macular degeneration, mental incapacity, low education, etc.)? What about those retirees who never got the letter? What about the covered spouses and children of these retirees who never saw any such letter?
Even for those retirees and dependants who understood, there are literally 57 different drug plans available, each with different premiums, copayments, deductibles, and formularies. How could they possibly digest all that and make a good choice? The only real way to compare 57 different plans is through Medicare.gov's interactive Plan Finder database. How many of these retirees are computer-savvy enough to go through that process? Even if you can type and navigate the website, try typing "hydrochlorothiazide" or "metronidazole" without errors. And all this under the deadline of the busiest time of the year for many, the holiday season, with plenty of snow and cold to contend with.
Then those retirees who were also members of the United Mine Workers of America (UMWA) got letters saying that, though the union disagreed with the coal companies that they could take away retiree health coverage for failure to enroll in a drug plan, the union was recommending that affected retirees go ahead and comply by enrolling while they advocated their position.
For those who got the letters, understood them, and needed help choosing and enrolling in a plan, there was very limited help available. The process of choosing a plan can be time consuming, even using the interactive web-based Plan Finder. This is especially true for folks who take numerous prescription drugs. The toll-free numbers for Medicare, many of the drug companies, and other helping agencies were virtually impossible to get through on during those last weeks of December. One Morgantown senior said she finally hung up after being on hold with Humana (one of the popular and cheaper plan providers) with 1 hour and 40 minutes, hoping to enroll to keep from losing her benefits. Another had a surgery scheduled for January 5, 2006. Even if she could get her healthcare reinstated after successfully enrolling, if it couldn't be done in a week, she would have to bear the huge costs of a surgery because of the lapse in coverage.
At the last possible minute, in the Gazette-Mail on Saturday, December 31, 2005, Cecil Roberts of the UMWA is quoted as saying that retirees from Peabody, Consol, Arch, and Bluestone will not lose their coverage if they have not enrolled in a drug plan by December 31, 2005.
And yet this morning we have reports of covered retirees going to pick up their monthly prescriptions at the same pharmacies they've gone to for years and being told suddenly that they have been "red-flagged," and no longer have any drug coverage at all. Even some who have successfully enrolled in plans, but have not yet gotten their cards and coverage info.
Some of these prescriptions are a matter of life and death. Imagine the impact that all this confusion and threats of having no more coverage can have on a sick elderly retiree.
We are currently attempting to verify the quotes in the article, and to find out if there is still some deadline for these Medicare-eligible retirees to get enrolled in a plan to preserve all their retiree health coverage. As soon as we have more detail and confirmation, we will post it here.
Happy new year.
What about those retirees who are very sick and whose lives depend on costly medical care? What about those retirees who couldn't read or understand their letter (perhaps because of illiteracy, macular degeneration, mental incapacity, low education, etc.)? What about those retirees who never got the letter? What about the covered spouses and children of these retirees who never saw any such letter?
Even for those retirees and dependants who understood, there are literally 57 different drug plans available, each with different premiums, copayments, deductibles, and formularies. How could they possibly digest all that and make a good choice? The only real way to compare 57 different plans is through Medicare.gov's interactive Plan Finder database. How many of these retirees are computer-savvy enough to go through that process? Even if you can type and navigate the website, try typing "hydrochlorothiazide" or "metronidazole" without errors. And all this under the deadline of the busiest time of the year for many, the holiday season, with plenty of snow and cold to contend with.
Then those retirees who were also members of the United Mine Workers of America (UMWA) got letters saying that, though the union disagreed with the coal companies that they could take away retiree health coverage for failure to enroll in a drug plan, the union was recommending that affected retirees go ahead and comply by enrolling while they advocated their position.
For those who got the letters, understood them, and needed help choosing and enrolling in a plan, there was very limited help available. The process of choosing a plan can be time consuming, even using the interactive web-based Plan Finder. This is especially true for folks who take numerous prescription drugs. The toll-free numbers for Medicare, many of the drug companies, and other helping agencies were virtually impossible to get through on during those last weeks of December. One Morgantown senior said she finally hung up after being on hold with Humana (one of the popular and cheaper plan providers) with 1 hour and 40 minutes, hoping to enroll to keep from losing her benefits. Another had a surgery scheduled for January 5, 2006. Even if she could get her healthcare reinstated after successfully enrolling, if it couldn't be done in a week, she would have to bear the huge costs of a surgery because of the lapse in coverage.
At the last possible minute, in the Gazette-Mail on Saturday, December 31, 2005, Cecil Roberts of the UMWA is quoted as saying that retirees from Peabody, Consol, Arch, and Bluestone will not lose their coverage if they have not enrolled in a drug plan by December 31, 2005.
And yet this morning we have reports of covered retirees going to pick up their monthly prescriptions at the same pharmacies they've gone to for years and being told suddenly that they have been "red-flagged," and no longer have any drug coverage at all. Even some who have successfully enrolled in plans, but have not yet gotten their cards and coverage info.
Some of these prescriptions are a matter of life and death. Imagine the impact that all this confusion and threats of having no more coverage can have on a sick elderly retiree.
We are currently attempting to verify the quotes in the article, and to find out if there is still some deadline for these Medicare-eligible retirees to get enrolled in a plan to preserve all their retiree health coverage. As soon as we have more detail and confirmation, we will post it here.
Happy new year.
Monday, December 19, 2005
Case of the Week: 12/23/05
County: Harrison
Age: 82
Our client contacted us after receiving a letter from her local Water Board that a complaint was made regarding her water meters. According to the complaint she has two water meters on her property in violation of the West Virginia Code of Sate Rules. My client had this arrangrment for more than 18 years with the authorization of the Water Board. Apparently she arranged it that way so her disabled son could reside in an adjoining trailer on her property. The letter my client recieved requested that she respond by the end of the month. I contacted the Public Service Commission and the Water Board. Under the Rules, the Water Board can make an exception. Because our client's son is disabled and the second water meter was previously authorized, the complaint will be dismissed. My client does not need to take further action and may keep both water meters.
Age: 82
Our client contacted us after receiving a letter from her local Water Board that a complaint was made regarding her water meters. According to the complaint she has two water meters on her property in violation of the West Virginia Code of Sate Rules. My client had this arrangrment for more than 18 years with the authorization of the Water Board. Apparently she arranged it that way so her disabled son could reside in an adjoining trailer on her property. The letter my client recieved requested that she respond by the end of the month. I contacted the Public Service Commission and the Water Board. Under the Rules, the Water Board can make an exception. Because our client's son is disabled and the second water meter was previously authorized, the complaint will be dismissed. My client does not need to take further action and may keep both water meters.
Friday, December 16, 2005
Case of the Week: 12/16/05
County: Randolph
Age: 62
This client contacted us when he received a bill from a health care provider that was 2 years old. The bill was for $1496. He recieved a summary from Medicare explaining the claim was made too late and he was only responsible for 20% of what Medicare would have paid had the claim been made properly. Working with a SHINE conselor, we were able to obtain a letter from CMS confirming that had the claim been submitted on time our client would have only been responsible for $110.22. Furthermore, the letter reiterated that my client is only responsible for the $110.22 eventhough Medicare never made a payment.
Age: 62
This client contacted us when he received a bill from a health care provider that was 2 years old. The bill was for $1496. He recieved a summary from Medicare explaining the claim was made too late and he was only responsible for 20% of what Medicare would have paid had the claim been made properly. Working with a SHINE conselor, we were able to obtain a letter from CMS confirming that had the claim been submitted on time our client would have only been responsible for $110.22. Furthermore, the letter reiterated that my client is only responsible for the $110.22 eventhough Medicare never made a payment.
Monday, December 12, 2005
Case of the Week: 12/9/05
County: Harrison
Age: 73
This client contacted us because she was having trouble collecting on a life insurance policy for her deceased husband. I contacted the insurance company on my client's behalf to check on the status of the claim and to provide information on where to find my client's deceased husband's medical records. The company acted quickly and reviewed my client's claim. After reviewing the claim it was determine that due to an error the policy was null and viod; however, the insurance company refunded the $700 her husband paid into the policy.
Age: 73
This client contacted us because she was having trouble collecting on a life insurance policy for her deceased husband. I contacted the insurance company on my client's behalf to check on the status of the claim and to provide information on where to find my client's deceased husband's medical records. The company acted quickly and reviewed my client's claim. After reviewing the claim it was determine that due to an error the policy was null and viod; however, the insurance company refunded the $700 her husband paid into the policy.
Friday, December 02, 2005
Case of the Week: 11/18/05
County: Hardy
Age: 76
This client is the legal guardian for her adult mentally disabled daughter. A doctor recommended sterilization for the daughter; however, declined to perform it without prior court authorization. My client felt that as a guardian she should be able to make this decision on her daughter's behalf. After researching the West Virginia Guardianship and Conservator Act I explained that some actions, like terminating parental rights, require prior court authorization. It is possible that since the procedure will render her daughter childless, prior court authorization is required. I also provided her with a copy of the relevant statute.
Age: 76
This client is the legal guardian for her adult mentally disabled daughter. A doctor recommended sterilization for the daughter; however, declined to perform it without prior court authorization. My client felt that as a guardian she should be able to make this decision on her daughter's behalf. After researching the West Virginia Guardianship and Conservator Act I explained that some actions, like terminating parental rights, require prior court authorization. It is possible that since the procedure will render her daughter childless, prior court authorization is required. I also provided her with a copy of the relevant statute.
Case of the Week: 11/11/12
County: Fayette
Age: 77
This client is the subject of predatory lending. She contacted us regarding her mortgage which she had fallen behind on. I reviewed the notice of foreclosing she received and the terms of her loan. One aspect of this case that hinted at predatory lending concerns insurance. Apparently the Mortgagor was charging the client for insurance even though she had her own. Also, the Mortgagor was very uncooperative about providing for a workout option for the client. I referred the client to Mountain State Justice. Interestingly, Mountain State Justice currently has other cases against the same Morgator who is a predatory lending.
Age: 77
This client is the subject of predatory lending. She contacted us regarding her mortgage which she had fallen behind on. I reviewed the notice of foreclosing she received and the terms of her loan. One aspect of this case that hinted at predatory lending concerns insurance. Apparently the Mortgagor was charging the client for insurance even though she had her own. Also, the Mortgagor was very uncooperative about providing for a workout option for the client. I referred the client to Mountain State Justice. Interestingly, Mountain State Justice currently has other cases against the same Morgator who is a predatory lending.
Case of the Week: 11/4/05
County: Berkeley
Age: 61
Client contacted us regarding bankruptcy. After determining that he is not judgment proof, I explained the changes in the new bankruptcy law and the differences in Chapter 7 and Chapter 13. He was mostly concerned about his car. I explained that under Chapter 7 his car can be reaffirmed or if below $2,400, can be completely exempted. Under Chapter 13 all property can be kept; however, since the only asset the client had was his car, Chapter 7 was recommended.
Age: 61
Client contacted us regarding bankruptcy. After determining that he is not judgment proof, I explained the changes in the new bankruptcy law and the differences in Chapter 7 and Chapter 13. He was mostly concerned about his car. I explained that under Chapter 7 his car can be reaffirmed or if below $2,400, can be completely exempted. Under Chapter 13 all property can be kept; however, since the only asset the client had was his car, Chapter 7 was recommended.
Case of the Week: 12/2/05
County: Mineral
Age: 77
This client contacted us after an energy company put power lines up over his property to an adjoining lot. He lives in a housing development and his understanding of the convenants and provisions is that an easement exits only for water, sewage, and drainage. I reviewed the Restrictive Covenants and Provisions and determined that although the provision in questions include water, sewage, and drainage, it does not specifically exclude electric. A reasonable reading of the document is that the energy company has an easement to the adjoining property. I explained a court may give it a different interpretation. Generally, when there is a difference of opinion on a term or provision in a document, the court can make a determination to end the conflict.
Age: 77
This client contacted us after an energy company put power lines up over his property to an adjoining lot. He lives in a housing development and his understanding of the convenants and provisions is that an easement exits only for water, sewage, and drainage. I reviewed the Restrictive Covenants and Provisions and determined that although the provision in questions include water, sewage, and drainage, it does not specifically exclude electric. A reasonable reading of the document is that the energy company has an easement to the adjoining property. I explained a court may give it a different interpretation. Generally, when there is a difference of opinion on a term or provision in a document, the court can make a determination to end the conflict.
Monday, October 31, 2005
Case of the Week: 10/28/2005
County: Cabell
Age: 62
Our client needed to know what sort of planning she needs to do to ensure that her adopted daughter will be cared for by her aunt should our client become unable to do so. I researched the West Virginia Code for available planning tools. Explained to the client that she can appoint a designated standby guardian should she become unable to care for her daughter. Explained the process for designating a standby guardian and sent her information about Conservatorship/Guardianship.
Age: 62
Our client needed to know what sort of planning she needs to do to ensure that her adopted daughter will be cared for by her aunt should our client become unable to do so. I researched the West Virginia Code for available planning tools. Explained to the client that she can appoint a designated standby guardian should she become unable to care for her daughter. Explained the process for designating a standby guardian and sent her information about Conservatorship/Guardianship.
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