DOCTORS QUIT? Is the Wall Street Journal becoming Faux News?

As Judy Lieberman of the Columbia Journalism Review reported on August 12th, the Wall Street Journal had printed a story called “More Doctors Steer Clear of Medicare: Some Doctors Opt Out of Program” on July 29, 2013, that last year, according to the Centers for Medicare and Medicaid Services, 9,539 physicians opted out of Medicare, up from 3,700 opting out in 2009. [A four-year period of time]

Dan Diamond of California Healthline looked at the same figures from the same source. What the Journal didn’t report is that also per CMS, the number of physicians who agreed to accept Medicare patients continues to grow year-over-year, from 705,568 in 2012 to 735,041 in 2013. [A one-year period of time]

A one percent drop of physicians wouldn’t be shocking given aging, retirement, sickness and death of physicians in the general population. But it is “shocking” if you write the story from an angle that sensationalizes and purposely attempts to mislead – not shocking that professionals get old and retire – but shocking that the WSJ is in danger of becoming a hack rag disguised as legitimate journalism.

When a person on SSI and Medicaid concludes a lawsuit for personal injuries, the Florida Medicaid agency swoops in and takes a big bite of the settlement or jury verdict to reimburse itself for the doctor and hospital bills caused by the person or corporation that hurt the disabled SSI/Medicaid recipient.  This action is based on the Florida Medicaid Third Party Liability Act, Florida Statutes, Section 409.910.

A few years ago, the U. S. Supreme Court substantially and appropriately reduced what Medicaid can get.  Click here for the Alhborn case.  Florida Medicaid has resisted the Supreme Court’s decision, but its position is now substantially weakened by a new U. S. Circuit Court of Appeals decision.

Based on a March 22nd U. S. Circuit Court of Appeals decision, more net settlement money is going to go to diasbled plaintiffs.  The court’s decision completely eviscerates the Florida Medicaid agency’s defense to avoiding the reduction in the Medicaid lien based on the U.S. Supreme Court Ahlborn decision in 2006. This is going to allow substantially MORE money to go into plaintiff’s Special Needs Trusts funded from  Personal Injury/Medical Malpractice settlements or jury verdicts.

Continue Reading Prediction: Florida Medicaid Liens will be reduced

The organizers of the Florida State Guardianship Annual Convention asked me to prepare some comments on Social Security, Medicare and Medicaid – It Just Keeps Changing.  The ten page paper highlights changes in how  attorneys and guardians of disabled individuals will have to change the way they interact with SSA, video hearings, “paperless” medical and legal files at SSA, as well as the 2008 changes in Medicare, and changes we are expecting in the SSI POMS that relate to Special Needs Trust administration: new rules on employment by the trustee of parents to care for minor disabled children, support of dependent spouses and minor children using the disabled parent’s trust funds (see our previous post on July 11th), and structured settlement annuity problems, particularly with deeming of healthy parents’ annuities against the disabled child’s continued eligibility for SSI and Medicaid.

If you want more information on guardianship, or the Florida State Guardianship Association and an application for membership, click here.

The four major programs fall nicely into a Matrix: the two columns are the monthly SSA payments (either RIB/DIB or SSI) which trigger the two major medical programs, Medicare and Medicaid.  The two rows indicate which two programs are insurance-based (RIB/DIB and Medicare) and which two are welfare programs with monthly means-testing for income and assets (SSI and Medicaid).

Some individuals get benefits from all four programs, called "Current Benefits" represented by the circle in the center of the Matrix.

We have attached a full explanation of the eligibility requirements for RIB and DIB, which trigger Medicare health insurance, and for SSI which triggers Medicaid eligibility.