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Archives for September 2015

Consider Creating A “Care Committee” For Your Special Needs Child

Special Needs TrustWhen setting up a special needs trust, we ask parents to designate someone to serve as their child’s trustee. The trustee’s job is to ensure the child receives the best possible care – without necessarily being the primary care giver.

The trustee oversees things like the child’s finances, overall health, housing, benefits and education. However, finding someone who is extremely knowledgeable in all of these areas and knows all of the members of your family and how they interact with one another – can be a challenge. As a result, we often recommend creating a Care Committee.

However, before we get to care committees, let’s do a quick refresher on special needs trusts. Special needs trusts are legal instruments specifically designed to hold property for a person with disabilities.

Every special needs trust has a trustee – the person responsible for managing the trust’s assets for the benefit of the person with the disability. A special needs trust gives the trustee very broad authority to use the trust funds in whatever way she thinks will best help the trust beneficiary given the beneficiary’s current and future needs and other resources.

Because the trustee of a special needs trust has these discretionary powers and cannot typically be forced to make distributions to the beneficiary, the funds in the trust do not harm the beneficiary’s ability to qualify for government benefits like Medicaid or Supplemental Security Income (SSI).

This brings us back to Care Committees. Since the trustee of the special needs trust cannot always be expected to know everything about the beneficiary’s care and needs, parents may decide to name several knowledgeable people to serve as a formal advisory committee.

The Committee can include any number of people, but it is typically composed of a small group that parents select because they understand the beneficiary’s needs. Committees are often made up of caregivers, doctors, social workers, family members, lawyers and other advocates. The Committee members are supposed to advise the trustee about the best way to utilize the trust assets, even though the trustee usually retains the ultimate authority over the disposition of the trust.

However, in some cases the trust will mandate that the trustee must follow the committee’s advice unless it is clearly against the beneficiary’s best interests.

The Care Committee also facilitates a conversation between the trustee and the beneficiary. Since this relationship can sometimes be difficult, especially if the trust beneficiary is fully competent and resents the trustee’s control over the assets, the Care Committee can advocate for the beneficiary’s needs without antagonizing the trustee.

The Committee can also take some of the pressure off of the trustee, because she will have help making difficult decisions that a lone trustee may agonize over.

Not all parents feel the need to create a Care Committee for a special needs trust, but if you are interested in establishing one, we can help you design the right committee for your family. Contact DJ Jeyaram at DJ@Jeylaw.com or 678-325.3872.

Two Things Every Special Needs Parent Should Know

Free workshop hosted by Jeyaram & Associates

Jeyaram & Associates is hosting a free workshop on how to win an appeal if you’ve been denied Katie Beckett and how to protect your special needs child’s benefits with a special needs trust.

DJ Jeyaram, Esq. is the leading Katie Beckett appeals expert in Georgia and the father of a special needs child. Mr. Jeyaram has intimate knowledge of the Katie Beckett appeals process and is a former administrative law judge.

After the presentation, Mr. Jeyaram will answer questions about appeal Katie Beckett denials and how to protect special need children’s benefits – now and in the future.

Special Needs Trust

  • Who: Special needs parents and caregivers
  • What: Free workshop presented by DJ Jeyaram, Esq.
  • When: October 22nd at 6:30 p.m.
  • Where: Kidspeech in Lawrenceville, GA

***Space is limited. Must RSVP to Lheyward@jeylaw.com by 10/17***

“Two Midnight Rule” Clarifies Reimbursements For Hospitals

Hospital ReimbursementIn 2013, the Centers for Medicare and Medicaid Services (CMS) announced the so-called two-midnight rule in an attempt to clarify when a patient should be designated to inpatient status versus outpatient status.

Hospitals are paid differently for treating inpatients versus outpatients. The rule addressed when surgical procedures, diagnostic tests and other treatments are generally considered appropriate for inpatient hospital admission under Medicare Part A.

The two-midnight rule attempts to set a bright line test: only patients that doctors expect to spend two nights in the hospital are considered inpatient.

Although the rule was set to take effect on October 1, 2015, CMS recently announced that it would postpone the enforcement on inpatient status reviews. The rule will now go into effect December 31, 2015.

Additionally, CMS proposed that it will consider stays a physician expects to last less than two midnights to be an inpatient admission relying on the judgment of the physician and the documentation justifying the stay on a case-by-case basis. For many in the healthcare industry, this appears to be a small step in the right direction.

Lastly, CMS announced that it will shift the responsibility of educating physicians and enforcement of the two-midnight rule to quality improvement organizations (QIO) from recovery auditors.

If you have questions about the Two Midnight Rule, please contact Kimberly Sheridan at ksheridan@jeylaw.com or 678-708-4702

Need Proof As To Why You Need To Conduct HIPAA Risk Assessments? Read On

HIPAAAn employee’s stolen laptop with unencrypted files led to a HIPAA investigation and ultimately a $750,000 settlement

The Department of Health and Human Services (HHS) recently issued a press release announcing a settlement with a 13-physician radiation oncology practice related to HIPAA violations. Cancer Care Group, P.C. settled allegations of HIPAA noncompliance for an amount of $750,000. One of the major factors that led HHS to conclude that Cancer Care was in widespread non-compliance with the HIPAA Security Rule was the practice’s failure to conduct a proper risk analysis.

HHS investigated the practice because of a HIPAA breach that occurred in 2013. The breach occurred when a laptop bad was stolen from an employee’s car. The laptop contained unencrypted files which included patient Protected Health Information (PHI) such as names, addresses, birth dates, Social Security numbers, and clinical information.

HHS notes that if Cancer Care had conducted an enterprise-wide risk analysis, they could have identified the removal of unencrypted backup media as an area of significant risk to Cancer Care’s ePHI and adopted policies and procedures to reduce such risk. HHS Office of Civil Rights Director, Jocelyn Samuels emphasizes that “organizations must complete a comprehensive risk analysis and establish strong policies and procedures to protect patients’ health information.”

HHS also notes that Cancer Care should have had a comprehensive device and media control policy in place. Failure to have a policy that outlined employee responsibilities when removing devices containing ePHI from the facility contributed to the breach.

This settlement is another reminder that health care practices should not ignore their obligation to conduct periodic comprehensive risk assessments. Failure to do so might put practice patient information at risk of breach and could be costly for the practice if it is investigated by HHS.

The full HHS Press Release is available here, and the Cancer Care Settlement Agreement is available here.

Please contact Danielle Hildebrand at dhildebrand@jeylaw.com or (678) 325-3872 if you have questions about conducting a risk assessment for your practice.

CMS Considers ICD-10 Test Run A Success

ICD 10 Success

With less than a month to go until the October 1 deadline for implementation of ICD-10 codes, many providers are nervous and wary of the readiness of the Centers for Medicare and Medicaid Services (CMS) systems.

According to CMS, there is little to worry about. CMS recently released the results of its July ICD-10 end-to-end testing and announced a success rate of 87%.

Approximately 1,200 voluntarily providers participated in the test.  

  • Of the 29,286 test claims received, 25,646 were accepted. (This is an 87% success rate.)
  • 1.8% of the test claims were rejected due to invalid submission of ICD-10 diagnoses or procedure codes.
  • 2.6 % of test claims were rejected due to invalid submission of ICD-9 diagnosis procedure code.  
  • Zero rejects due to front-end CMS issues.

If you are a provider, these statistics should be comforting. However, the 13% error rate is still a cause for concern. Add that number to that fact that the ICD-10 codes will have 68,000 diagnosis and procedure codes FIVE times the number of ICD-9 codes, and it can be a bit overwhelming.

Remember that that upon implementation, ICD-10 codes will be required for all HIPAA covered entities.  

Please contact Kimberly Sheridan at ksheridan@jeylaw.com or 678-708-4702 if you have questions about ICD-10 implementation.

Congratulations To Jeyaram & Associates For Being Featured In The Business News Daily

Reprinted with permission from the Business News Daily
Special Needs Trusts

 

Owner DJ Jeyaram Esq. shared the story behind Jeyaram & Associates, a family-focused law firm that specializes in special needs trusts, wills, estate planning and healthcare legal services.

My son Kai, pictured in this photo, was born with a rare genetic condition called Williams Syndrome. He brings us an amazing amount of joy despite all of his challenges.

Soon after my son was born, we realized that we needed a plan to protect him in case anything happened to me or my wife, so we began offering special needs trusts, which help protect children’s current and future government benefits.

I started my business in 2007 after working at a large law firm. I realized that most special needs families could not afford my big firm rates and I was forced to refer these families to small firm attorneys that did not necessarily have the proper training to set up a special needs estate plan. Three months later, I hung out my shingle and have successfully been in business for more than 8 years. It’s been one of the best decisions I ever made.

One of the biggest challenges we face is limiting the number of pro bono cases we take every year. Because we have a special needs child and are ingrained in the special needs community, we meet a lot of families that need legal help but don’t have the necessary resources. We want to help everyone because we always think ‘That could be us.’