Wills, Trusts & Estates Prof Blog

Editor: Gerry W. Beyer
Texas Tech Univ. School of Law

A Member of the Law Professor Blogs Network

Sunday, April 26, 2015

Ask Math Not Facts to Detect Cognitive Impairment Early

MathResearchers of dementia and cognitive impairment warn that many individuals can still recall common facts, such as the date or who the president is, in the early stages of impairment. However, losing ability to do simply math and understanding finances can come earlier in the development of diseases such as  Alzheimer's. Detecting declining ability to handle finances early can help protect older individuals from exploitation.

See Tara Siegel Bernard, As Cognition Slips, Financial Skills Are Often the First to Go, New York Times, Apr. 24, 2015.

Special thanks to Joel Dobris (Professor of Law, UC Davis School of Law) for bringing this article to my attention.

April 26, 2015 in Disability Planning - Health Care, Disability Planning - Property Management, Elder Law | Permalink | Comments (0) | TrackBack (0)

Friday, April 24, 2015

Long Term Care Tax Breaks

LTCiA long-term care insurance (LTCi) policy may help people reduce the amount they pay in taxes.  At the same time, it also provides valuable insurance coverage that can help someone stay in their home, protect their retirement, and ensure they will be self-sufficient. 

Furthermore, the new rules under the Pension Protection Act permit consumers to pay for LTCi through a tax-favored exchange from a non-qualified annuity directly into a stand-alone LTC policy without causing a taxable event.  Below are other benefits to LTCis:

  • Premiums Tax-Deductible.  Individual policyholders may be able to deduct a portion of the premium paid for a tax-qualified LTCi policy (known as an eligible premium).  This can be counted towards unreimbursed, itemized medical expenses. 
  • Tax Free Policy Benefits.  Benefits received under a tax-qualified reimbursement LTCi policy could be tax free; policies providing a per-diem can be received tax-free so long as they do not exceed the greater of actual qualified long-term care daily expenses or the IRS’s per day limitation.
  • Deductible Out of Pocket Expenses.  Typically, any LTC expenses the policyholder pays out-of-pocket may be claimed as a medical deduction on a federal income tax return.
  • States Offer Deductions.  A number of states currently offer tax deductions and/or credits for those who purchase qualified LTCi policies.

See David Hillelsohn, Tax Benefits for Long Term Care Insurance, The LTC Buzz, Apr. 15, 2015.

Special thanks to Brian Cohan (Attorney at Law, Law Offices of Brian J. Cohan, P.C.) for bringing this article to my attention.

April 24, 2015 in Disability Planning - Health Care, Estate Planning - Generally, Non-Probate Assets | Permalink | Comments (0) | TrackBack (0)

Thursday, April 23, 2015

Incapacity Planning

Healthcare proxySome of the lesser-known benefits of a well-crafted estate plan are the provisions providing for both management of assets and instructions for personal care in the event of incapacity.  Estate planning documents that anticipate incapacity enable named representatives to manage an individual’s assets, and direct how health care decisions will be made.  Without these documents, family members may have to petition a court to attain power to manage the assets or make health care decisions for one who is incapacitated. 

The first document necessary in planning for incapacity is the durable power of attorney.  This document survives incapacity and gives a designee the authority to act on one’s behalf with regard to financial affairs.  The durable power of attorney is valid once the testator signs it, so selection of designee is imperative.  The next set of documents concerns heath care; and includes a health care proxy, living will and HIPAA authorization.  A health care proxy will give a designee the power to make health care decisions on one’s behalf.  A living will or advance directive can provide directions to caregivers and loved ones with regard to care or end-of-life matters.  A HIPAA authorization allows doctors to disclose important health information to caregivers. 

See Planning for Incapacity re: Estate Planning, The National Law Review, Apr. 23, 2015.

Special thanks to Jim Hillhouse for bringing this article to my attention.

April 23, 2015 in Disability Planning - Health Care, Disability Planning - Property Management, Estate Administration, Estate Planning - Generally, Wills | Permalink | Comments (0) | TrackBack (0)

Tuesday, April 21, 2015

Social Security Numbers to be Removed From Medicare Cards

Medicare Card SampleIn the coming years, Medicare benefits cards will no longer include the recipients social security number. Prompted by a desire to lower the risk of identity theft for those carrying benefits cards, a bill recently signed by President Obama requires a new identification system to be created for Medicare cards. The change will take time though, with a four year period allotted for creating the new system and beginning to issue the new cards, and another four years to get all current recipients the new cards.

See Robert Pear, New Cards for Medicare Recipients Will Omit Social Security Numbers, New York Times, Apr. 20, 2015.

Special thanks to Lewis Saret for bringing this article to my attention.

April 21, 2015 in Disability Planning - Health Care, Non-Probate Assets | Permalink | Comments (0) | TrackBack (0)

Saturday, April 18, 2015

Congress Ends Coverage of Medicare Part B Deductible

Medicare taxMedicare beneficiaries typically purchase “Medigap” insurance, which pays for most of Medicare’s deductibles and copayments.  However, Congress recently passed legislation that will no longer allow Medigap plans to offer coverage of the Medicare Part B deductible, beginning in 2020.  Current Medigap policyholders and those buying policies before 2020 will still be eligible for the deductible coverage after that date. 

This new change is to help pay for the “doc fix” legislation that overhauls the way Medicare pays doctors and that is expected to cost $200 billion over 10 years.  The reasoning behind making Medicare beneficiaries pay the deductible themselves is that it will make them rethink the decision to go to a doctor and perhaps costing the Medicare system superfluous expenses.

See Congress Schedules End to Insurance Coverage of Medicare Part B Deductible, Elder Law Answers, Apr. 17, 2015. 

April 18, 2015 in Disability Planning - Health Care, Elder Law, Estate Planning - Generally, New Legislation | Permalink | Comments (0) | TrackBack (0)

Wednesday, April 15, 2015

Family Mourns Mother's Death After Life Support Allegedly Prematurely Pulled

Life supportWhen Deanna Leblanc, 39, was placed on a respirator her family had not discussed terminating life support.  However, when Joanna Flynn began her shift in the ICU at Georgian Bay General Hospital, Mrs. Leblanc died 90 minutes later.

Now, Flynn is facing manslaughter and criminal negligence charges for allegedly cutting off Mrs. Leblanc’s life support without consent.  Flynn was released last Thursday on a $50,000 bail and the agreement that she would not work “in a field where she has contact with patients.”

Mr. Leblanc sent a written statement to reporters entitled, “WHY.”  He explained the heartbreak and confusion surrounding his wife’s death and demands an explanation.  “My boys and I deserve answers.  I am hoping someone will help us find those answers and prevent such horrible mistakes from happening in the future.” 

See Eric Andrew-Gee, Husband, Sons, Mourn Woman Who Died After Life Support Allegedly Pulled, The Star, Apr. 11, 2015.

April 15, 2015 in Disability Planning - Health Care | Permalink | Comments (0) | TrackBack (0)

Luxurious Amenities to Lure Medicare Patients

Nursing homeIn a cutthroat race for Medicare dollars, nursing homes are luring patients who are leaving a hospital and need short-term rehabilitation with luxuries such as decadent baths and calming waterfalls.  Yet, even as nursing homes invest in lavish living quarters, the quality of care is very uneven.  Many of the homes are unable to provide the intensive medical care that rehabilitation requires.

The Department of Health and Human Services released a report in 2014 indicating that 22 percent of Medicare patients who stayed in a nursing facility for 35 days or less experienced harm as a result of their medical care.  Experts say that nursing homes were not built for this purpose; many patients leave hospitals with acute medical needs. 

Competition for these patients has become intense because Medicare pays 84 percent more for short-term patients than nursing homes generally get from Medicaid for long-term patients. 

See Katie Thomas, In Race for Medicare Dollars, Nursing Home Care May Lag, The New York Times, Apr. 14, 2015.

Special thanks to Lewis Saret for bringing this article to my attention.

April 15, 2015 in Current Affairs, Disability Planning - Health Care, Elder Law, Estate Planning - Generally | Permalink | Comments (0) | TrackBack (0)

Friday, April 10, 2015

Montana Declines to Criminalize Doctors Aiding Patient Suicide

Physician assisted suicideThe Montana state senate committee recently declined to pass a bill that would criminalize doctors prescribing life-ending drugs to their terminally ill patients.  In 2009, the Montana Supreme Court legalized physician assisted suicide, allowing mentally competent adults to be prescribed fatal doses of medication. 

Montana’s governor signed Senate Bill 142 just last week, which codifies the “right” to try drugs that are still in the clinical trial phases of testing.  In passing this legislation, Montana has joined twelve other states including Louisiana, which enacted House Bill 891 and allows patients with terminal illnesses to obtain drugs not yet approved by the FDA.  This law allows doctors, hospitals and manufacturers to bypass the FDA and shield them from prosecution.  Opponents of these laws argue any unapproved drugs could endanger the lives of patients, whereas proponents claim this could give people access to life-saving treatments. 

See Senate Rejects Bill Criminalizing Doctors Who Aid Patient Suicide, Harrell & Nowak Law, Apr. 8, 2015. 

Special thanks to Sean Malseed for bringing this article to my attention.

April 10, 2015 in Current Affairs, Disability Planning - Health Care | Permalink | Comments (0) | TrackBack (0)

Tuesday, April 7, 2015

Beating All Odds

Life supportWhen a motorcycle accident left 28-year-old Matt Davis in a coma and on life support, doctors said there was a 90 percent chance he would never wake up.  Yet Danielle, Mr. Davis’ wife of seven months, refused to pull the plug on her husband and eventually moved him into her mother’s home and became his fulltime caretaker.  After months of rehab, Mr. Davis is now able to walk on his own two feet.  Although he is not fully recovered, he and his wife are doing great. 

See ABC News, Wife Refuses to Pull Plug on Husband After Crash, Then He Wakes From Coma, 9 News, Apr. 7, 2015.

April 7, 2015 in Disability Planning - Health Care | Permalink | Comments (0) | TrackBack (0)

Monday, April 6, 2015

Inducements for Organ Donation

Organ donationAccording to the American Journal of Nephrology, living donors incur out-of-pocket expenses averaging around $5,000.  Although a recipient’s insurance covers the donor’s medical expenses, it will not cover transportation, lodging, childcare, lost wages and the like.  It is possible that taking these burdens off donors and their families could lead to more organs for transplant, and experts are urging Americans to find ethical ways to rid financial “disincentives” to organ donation. 

OneLegacy, the nation’s largest organ procurement organization, believes “the donor should bear no economic detriment.”  Upfront cost coverage would result in long-term savings among insurers by facilitating organ donation.  “From every single patient that stays on dialysis, the payer is losing $60,000 a year if they are not transplanted.”  But regardless of existing financial barriers, offering incentives to living donors is “so ethically charged.”  Some maintain that donors should receive lifetime health coverage, while others suggest coverage for a specified period.  Although nothing has come of this idea, experts believe discussions should be initiated with patients, families and payers.

See Randi Belisomo, Remove Financial Barriers to Organ Donation, Experts Say, Reuters, Apr. 6, 2015.

April 6, 2015 in Disability Planning - Health Care, Estate Planning - Generally | Permalink | Comments (0) | TrackBack (0)