How to Protect Yourself From Medical Identity Theft

In 2011, 200 people in Arizona, Florida, Michigan and New Jersey received almost $9.6 million in Medicaid benefits. The problem? They were already dead when they received these benefits. Claiming services in the names of the deceased is just one of several examples of medical fraud, specifically medical identity theft. You may be familiar with run-of-the-mill identity theft, but its lesser-known cousin can be more enduring. Regular identity theft may involve a credit card or bank account number that may be protected by a loss limit, or by insurance through the banking institution or the FDIC.

Unfortunately, the information that is stolen in medical identity theft (e.g., your name or Social Security number) is not something you can change as easily. Unfortunately, the damages associated with medical identity theft also don’t have limits. The thief may use your identity to obtain medical services, buy prescription drugs or submit false claims in the patient’s name. Victims often foot the bill for damages. One recent study found that 65 percent pay an average of $13,500 to resolve the crime, and only 10 percent of victims achieve a completely satisfactory resolution. Medical identity theft usually occurs locally. In other words, the majority of health care data breaches result from a lone computer being stolen rather than hacking into an organization’s mainframe data system.

Among these common thefts, two-thirds happen when a laptop or tablet is stolen, or when an unauthorized person accesses records via email, a computer terminal or network server. Moreover, 22 percent of breaches still involve paper records.

To prevent medical identity theft and other types of health care fraud:

 • Don’t give out your Medicare, Medicaid or Social Security numbers to unauthorized people

 • Keep records of your doctor visits, tests and procedures in a health care journal or on a calendar

• Review your Medicare Summary Notices and Part D Explanation of Benefits to compare the services that were billed against the dates and procedures performed, as recorded in your journal or calendar

• Carefully review your billing statement to check for charges for something you did not receive, double billing for the same thing (even though a different term may be used), and any services you did not receive and that were not ordered by your doctor

• Whenever you visit a medical provider, don’t be shy about asking questions about his recommendations, whether or not certain tests or procedures are necessary and what they will reveal, and if there are less expensive options

 • Always call your provider(s) if you have questions about your bill If you suspect any fraud, you are the front line to save taxpayers billions of dollars each year.

You can report your findings to an agency that will investigate further. Remember, while most health care fraud is committed by a small minority of unscrupulous health care providers, they tend to repeat their scams often, so the more reports received from victims, the better the chances that they will be identified and convicted.

To report your suspicions, collect the following information to help verify your claim:

 • The provider’s name and any identifying number you may have • Information regarding the service or item you are questioning

• The date the service or item was supposedly given or delivered • The payment amount approved and paid by Medicare

• The date on your Medicare Summary Notice • Your name and Medicare number (listed on your Medicare card)

 • The reason you think Medicare should not have paid the claim to the provider

To report suspected errors, fraud or abuse, you can contact either the Office of Inspector General for the Department of Health & Human Services at 800.447.8477 (TTY: 800.377.4950), the Report Fraud Online at http://oig.hhs.gov/fraud/report-fraud/index.asp, the Centers for Medicare & Medicaid Services at 800.633.4227 (TTY: 877.486.2048) or the Medicare Beneficiary Contact Center at mailing address P.O. Box 39, Lawrence, KS 66044.

1. Government Accounting Office. May 14, 2015. “Medicaid: Additional Actions Needed to Help Improve Provider and Beneficiary Fraud Controls.” http://www.gao.gov/products/GAO-15-313. Accessed July 8, 2015.

2. Ponemon Institute. February 2015. “2014 Fifth Annual Study on Medical Identity Theft.”http://medidfraud.org/2014-fifth-annual-study-on-medical-identity-theft/. Accessed July 8, 2015.

3. HealthDay. April 14, 2015. “Unauthorized Breaches of Medical Records on the Rise.” http://consumer.healthday.com/bone-and-joint-information-4/computer-related-health-news-143/unauthorized-breaches-of-medical-records-on-the-rise-698366.html. Accessed July 8, 2015.

4. Stop Medicare Fraud. 2015. http://www.stopmedicarefraud.gov/reportfraud/index.html. Accessed July 8, 2015

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Assessing Risks Reduces Severity, Frequency of Falls - AGT The Safe Money People

Following the adage “Knowledge is power” can literally keep us from falling down. In the U.S., one out of every three people over 65 takes a tumble each year, and 20 to 30 percent of those who survive incur moderate to severe injuries. Yet, those who have taken the time to assess the risk of falling in their homes are less likely to be in that one-third.1 It may not be surprising that, once someone has taken a spill, they inherently develop a fear that makes them more cautious about preventing another fall. For the majority of the population, that’s a good instinct. But for seniors, it can make them withdraw from certain activities. Ironically, this new caution can increase their risk of falling again, particularly by preventing them from taking routine walks or another form of exercise. To help address this phenomenon, the U.S. Department of Health and Human Services sponsored a study to measure whether a personalized program of intervention could help reduce the risk of an older person taking a fall. The program includes an in-home physical, emotional and cognitive functioning evaluation, a detailed record of a person’s history of falls, an assessment of the home environment and an inventory of current medications that may impact the person’s sense of balance. All of these factors are taken into consideration and used to create a customized recommendation for the individual. Some risk factors are intrinsic, meaning they are linked to the person’s health and habits. Other risks are extrinsic, which refers to those associated with the home environment.” As part of the study program, participating seniors are educated on both types of risks and how they may be avoided. For example, someone who routinely gets up to go to the bathroom in the middle of the night may have been doing it for so long they do not need to turn on a light. However, as they age, their senses may not be as sharp and they may not notice a new obstacle in the path. Installing a nightlight to guide their path to the bathroom could be a simple solution that greatly decreases their fall risk. Participants in the study who received intervention training and recommendations experienced a 13 percent lower rate of falls than ones who did not, and those who did experience falls were less likely to suffer a serious injury. Moreover, their long-term insurance claims were 33 percent lower over a three-year period, suggesting that this awareness may have had a long-term impact on both cognitive and physical health. This isn’t terribly surprising, seeing as the study also found participants were nearly 20 percent more likely to make fall-preventing modifications to their home than nonparticipants. 1. ThinkAdvisor.com. Aug. 3, 2015. “Elders’ Risk of Falling Is Falling.” http://www.thinkadvisor.com/2015/08/03/elders-risk-of-falling-is-falling. Accessed Aug. 5, 2015.

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Downsizing Can Help Retirement Savings Last - AGT The Safe Money People

Ideally, in retirement, you reduce your monthly expenses. No more commute, less need for work-related clothes and dry cleaning, and the ability to eat lunch at home every day. But is it enough savings to balance the lack of income from work? If you’re like many retirees, near-retirees or even those just starting to plan for retirement income, you may have an uneasy feeling about just how much money you’ll need and how long you’ll need it to last. If you’re just not feeling confident about it, there is one thing you can do to help: Downsize. Downsizing to a less expensive condo, townhouse, apartment or smaller home offers numerous savings advantages, from reducing your monthly mortgage or rental costs, to lower maintenance, property tax and utility bills. If you’re thinking of moving out of state, perhaps to a locale where you’ve vacationed and dreamed of living for years, consider the pros and cons of what living there year-round may mean. Is it a dreary place in winter, or too hot in the summer? Does it feature a year-round community where you can make friends with locals, or is it pretty much abandoned when tourists or snow-birds are gone — and could you bear that? Oftentimes those lovely vacation spots can be quite isolated during the off-season. It may come down to your basic personality and disposition: do you prefer the opportunity to make good friends and always have people around with whom to spend time, or would you be OK with getting away from it all and minimizing outside relationships, at least for part of the year? Consider, too, how your spouse’s answers may differ to those same questions. Then, too, you should examine the practical side of relocating. For example, will the cost of living be higher or lower than where you currently live, and what can you expect in terms of health care and other expenses and amenities? After all, your large family home may not be as expensive as a tiny condo on the beach, complete with high monthly expenses and high property taxes. If you plan to move to another state, you will need to investigate tax and estate laws to see if you’ll need to update your wills and trusts. If you have a network of trusted financial professionals and attorneys, you may want to check if they are licensed to continue working with you in the state where you want to relocate. Then again, you could just move to a smaller place in your current neighborhood or community. You may opt to live closer to relatives, which can offer the potential for significant savings when it comes to home care in your later years. If so, consider features in a new home that will be more convenient as you venture gracefully into old age, such as a single-story home with a low-maintenance yard and accessibility features. Also think about your locale of choice — such as whether you’d like to move to a more urban scene in a trendy downtown location near art galleries, museums, fine restaurants and concert halls. Perhaps a condo with a skyline view, concierge and doorman would fit the bill. After all, if you spent the majority of your adult life raising a family in suburbia, retirement may be the time to enjoy other types of entertainment. A third option is to move to a senior living community. According to a survey by the Demand Institute Housing & Community, one in five baby boomers is considering relocating to a senior-related housing or active-adult community. While many of these campuses have come a long way in featuring more cultural and upscale amenities, many still suffer from a reputation of the proverbial “old folk’s home.” The key to downsizing — or what some prefer to call “right-sizing” — is to make the right decision for your lifestyle and finances. Some retirement-oriented communities may offer work and entrepreneurial opportunities so you can get out and about, make new friends and contribute to your retirement income. Do not under-estimate the value of a strong social network comprised of people of all ages. After all, if you’re going to live a long and healthy life, why not live it among friends? 1. Media Post. May 15, 2015. “Redefining Senior Living for Boomers through the Name Storm Project.” http://www.mediapost.com/publications/article/248470/redefining-senior-living-for-boomers-through-the-n.html. Accessed Aug. 5, 2015.

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New Job, Older Worker | AGT The Safe Money People

Some married couples watch a newly divorced friend re-enter the dating pool and think, “Oh thank goodness we don’t have to do that.” Similarly, many older workers who are secure in their career or job thank their lucky stars when they learn that another mature worker has been laid off or, for one reason or another, is having to look for a new job. Let’s face it, some things are simply easier for young folks, and dating and job seeking are generally two of them. But the reality is, many mid-career workers have had to work hard to find a new job during this recent period of high unemployment. At the same time, more people are undergoing career changes midway through their career — and that in itself can cause stress. But here’s some good news: According to a 2014 survey by the American Institute for Economic Research (AIER), a large majority of mid-career workers who sought a career change (whether voluntary or forced) after age 45 found that their new positions led to less stress and felt their results were successful. In fact, 72 percent of respondents agreed with the statement, “I feel like a new person.” Sixty-five percent said their stress levels dropped. One explanation for the lower stress may be explained by another study that revealed older workers frequently move from a management position to a non-management position. And here’s some more good news: Half of the survey participants reported that although they may have initially taken a lower-paying position, eventually their pay increased. Other findings from the study reveal that people with some college education fare best when it comes to making a career change. First of all, workers with no more than a high school diploma are less likely to change careers. Second, professionals with graduate degrees are also less likely to change careers, presumably because they have spent so much time acquiring specialized skills and knowledge that it may be difficult to translate that experience into a new career. So it turns out that your basic college graduate with a general BS or BA degree is more likely to make a career change. Another interesting fact is that older men are slightly more likely to make a career change than older women. Income Differential If you are mid-career or later, you may have noticed that your salary bumps aren’t quite what they used to be. That’s because the greatest salary jumps come between the ages of 25 and 35, and then earnings begin to plateau. In fact, a recent study found that by age 45 to 55, earnings are considered to be shrinking because they no longer keep up with inflation. Here’s another interesting fact from the same study. Higher income earners who experience a salary disruption, such as being laid off, are less likely to recover their previous level of earnings than lower-income earners. At the lowest income levels, a negative shock is likely to return to a previous high level within 10 years, and subsequent increases generally continue. At higher income levels, an income decline may or may not return to a previous high level, and subsequent increases tend to be low. Age Discrimination Does age discrimination still exist in the job market? Most research concludes it does. In today’s job market, about half of all baby boomer job seekers say they felt they were discriminated against due to their age, at least in terms of working as much as they would have liked. One study — narrowly focused only on women seeking entry-level positions — nonetheless found that younger workers were 40 percent more likely to be called back for an interview than older workers. However, legal recourse for age discrimination is much harder to prove than it is for race or gender discrimination. For one thing, it’s difficult to tell if an employer rejects an older applicant due to age or because he or she is overqualified for the position and therefore seeking a higher salary than is necessary to pay for that particular role. It is also difficult to tell if an older worker is laid off due to his or her age or is one of many as part of a workforce reduction or reorganization. In order to win a lawsuit for age discrimination, there must be concrete evidence to that effect. For example, either written documentation (such as an email or memo) or witnesses to a verbal confrontation in which a supervisor referred to the worker as some type of derogatory term that indicates ageism discrimination. Late last year, another study found that it takes five months longer for an older worker to find a job than a younger person with similar qualifications. Unfortunately, the study could not determine if older people are less aggressive in their search because they have enough financial resources to be patient and discerning. Boston College Center for Retirement Research. April 23, 2015. “Late-Career Job Changes Reduce Stress.”http://squaredawayblog.bc.edu/squared-away/late-career-job-changes-reduce-stress. Accessed May 6, 2015. Boston College Center for Retirement Research. April 28, 2015. “Around 50, U.S. Workers’ Earnings Fall.”http://squaredawayblog.bc.edu/squared-away/around-50-u-s-workers%E2%80%99-earnings-fall/. Accessed May 6, 2015. Boston College Center for Retirement Research. April 21, 2015. “Employer Bias Against Aging Boomers?”http://squaredawayblog.bc.edu/squared-away/employers-bias-against-aging-boomers/. Accessed May 6, 2015.

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Palliative Care: What It Is, What It Is Not

Palliative care emerged in the 1980s as a holistic, team approach to supporting patients suffering from serious medical conditions. It is not the same thing as hospice care. While both focus on making the patient more comfortable, the difference is that hospice is called for when the patient has a prognosis of impending death. Palliative care, quite on the other hand, focuses on life. The difference between the two is significant, but not widely known. In fact, more than 78 percent of adults in the United States are not exactly sure what palliative care is.

1 Even some members of the medical community believe that palliative care is just a synonym for hospice. Some doctors understand the difference but don’t recommend palliative care because they’re concerned the patient may interpret it to mean hospice and believe that they’re dying. Moreover, more than 50 percent of directors of nursing do not understand the basics of palliative care, according to new study. This research found that the more familiar the director of nursing was with palliative care, the greater the chances that their patient’s experienced end-of-life cares aligned with a higher quality of life focus. While hospice patients no longer receive curative treatment for their underlying disease, palliative care is available at any stage of illness and can be deployed in conjunction with curative treatment.

It is not associated with any particular age, illness or stage of illness, and is appropriate for anyone suffering from a serious illness, whether chronic or acute. Team Approach, Palliative care is provided by a team of professionals, usually in concert with the patient’s primary physician for a specific condition. This team is developed to meet the special needs of each patient and therefore can vary significantly. Examples of palliative care team specialists include trained palliative care doctors and nurses, social workers, psychologists, dietitians, nutritionists, massage therapists, pharmacists, chaplains and even art or music therapists — whatever is most appropriate for the patient.

Even if the primary physician is not technically a member of the palliative care team, he supervises the patient’s care and plays an active role in ongoing treatment. The healing scope of the palliative care team is broader than that of traditional doctors. Their focus is on preventing pain, alleviating suffering, improving quality of life and helping both the patient and his loved ones cope with the stress and burden of caregiving. The team works to make the patient become as independent as possible, emphasizing what the patient actually wants instead of what a traditional medical approach might dictate that he needs. This approach gives patients more control over their treatment plan. For example, an aging parent diagnosed with cancer may be worried about who will care for his mentally incapacitated adult son to the degree that he forgoes scheduled treatments to stay home with the dependent. This scenario may call for a social worker who is able to procure resources to help care for the son and provide transportation to and from chemotherapy sessions for the father.

 A palliative care team addresses physical, mental and social conditions, and studies have revealed that curative treatment can also be more effective when accompanied by palliative care. Access Because palliative care is not that well known, access is an issue. Most of the time it is recommended by the treating physician and frequently provided by on-site teams in a hospital setting. However, palliative care can be provided wherever the patient is located, including outpatient clinics, long-term-care facilities, hospices and even at home.

Palliative care also can be recommended via other sources, such as health and mental health agencies, day care and senior centers, schools, courts, child welfare and family service agencies, correctional systems, agencies serving immigrants and refugees, substance abuse programs and employee assistance programs. While the foundation of the program is to provide pain and symptom relief, these types of organizations may be engaged due to the patients’ lifestyle, socio-economic factors, immigration status and/or living environment. Social service agencies are frequently able to identify these factors and refer patients who would benefit from palliative care before their conditions are exacerbated and require more costly treatment.

Palliative care is generally covered all or in part by Medicare, Medicaid and most insurance plans. However, Medicaid coverage can vary depending on the state program.

1. Health Affairs Blog. March 10, 2015. “Effective Public Engagement To Improve Palliative Care For Serious Illness.”http://healthaffairs.org/blog/2015/03/10/effective-public-engagement-to-improve-palliative-care-for-serious-illness/. Accessed April 14, 2015.

 2. Journal of Hospice and Palliative Nursing. October 2012. “Opportunities and Challenges for Palliative Care Professionals in the Age of Health Reform.” http://www.nursingcenter.com/lnc/cearticle?tid=1429239. Accessed April 8, 2015.

 3. NYmag.com. “Many Nursing Homes Fall Short at Palliative Care.” March 24, 2015.http://nymag.com/scienceofus/2015/03/many-nursing-homes-fall-short-at-palliative-care.html. Accessed April 8, 2015.

 4. Pharmacy Practice News. March 2015. “Palliative Care a ‘Foreign’ But Vital Role for Pharmacists.”http://www.pharmacypracticenews.com/ViewArticle.aspx?d=Clinical&d_id=50&i=March+2015&i_id=1155&a_id=30832. Accessed April 8, 2015.

5. National Association of Social Workers. “NASW Standards for Palliative & End of Life Care.”https://www.socialworkers.org/practice/bereavement/standards/default.asp.” Accessed April 8, 2015. 6. GetPalliativeCare.org. “Frequently Asked Questions.”http://getpalliativecare.org/whatis/faq/#how-do-i-know-if-palliative-care-is-right-for-me. Accessed April 8, 2015.

Is Your Cash Gift Taxable?

Parents and grandparents often dole out “gifts” to the children to help with various and sundry expenses. But when is a cash gift taxable to the recipient? Gifts up to $14,000 from an individual (or $24,000 from a legally married couple) aren’t taxable, according to the IRS, but you may have to pay taxes on anything that exceeds that amount. Here are more considerations to bear in mind regarding non-taxable cash gifts: • Gifts made to a legally married spouse are never taxable. • Tuition or medical expenses paid directly to a medical or educational institution on someone else’s behalf are not taxable. • Gifts made to a political organization for its use are not taxable. • Gifts made to charities are not taxable. Also note that you may not be able to deduct the amount you gift from your income tax, with the exception of qualified charitable contributions. IRS.gov. April 1, 2015. “Seven Tips to Help You Determine if Your Gift is Taxable.” http://www.irs.gov/uac/Seven-Tips-to-Help-You-Determine-if-Your-Gift-is-Taxable. Accessed April 1, 2015.