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GeorgiaCares Referring, Educating And Training News

.E.A G .R
Car eorgia G

ews ining N Tra g, And atin , Educ rring s Refe e

VOLUME 5. ISSUE 1 JANUARY 2013

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Cost-Of-Living Adjustment (COLA) for 2013

Source: www.socialsecurity.gov/cola/ For 2013, monthly Social Security and Supplemental Security Income (SSI) benefits will increase by 1.7 percent. This cost-of-living adjustment (COLA) for SSI beneficiaries began December 31, 2012 and Social Security beneficiaries will see the increase in their January 2013 benefits. The purpose of the COLA is to ensure that the purchasing power of Social Security and Supplemental Security Income (SSI) benefits is not eroded by inflation. It is based on the percentage increase in the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W) from the third quarter of the last year a COLA was determined to the third quarter of the current year. If there is no increase, there can be no COLA. The CPI-W is determined by the Bureau of Labor Statistics in the Department of Labor. By law, it is the official measure used by the Social Security Administration to calculate COLAs. Congress enacted the COLA provision as part of the 1972 Social Security Amendments, and automatic annual COLAs began in 1975. Before that, benefits were increased only when Congress enacted special legislation. Unlike the Social Security COLA, the CPI-W plays no part in the computation of the Medicare Part B premium. The Medicare Part B premium changes each year, if necessary, so that the Part B premium is sufficient to fund approximately 25 percent of the projected cost of the Part B program. Any such premium change is effective in January. For some beneficiaries, their Social Security increase for 2013 may partially or completely be offset by the increases in Medicare premiums. For more information on the 2013 Medicare premium and deductible rates, see page 2 (Counseling Tips). To contact the Social Security Administration, visit the www.socialsecurity.gov website or call toll-free at 1-800-772-1213 Monday through Friday 7:00 a.m. until 7:00 p.m. Be sure to check the office hours of your local SSA office before visiting.

Inside This Issue:

GeorgiaCares News Counseling Tips Program Highlights Spotlight on Scams 1 2 3-4 5

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GeorgiaCares Referring, Educating And Training News

Counseling Tips
MEDICARE PREMIUM AND DEDUCTIBLE RATES 2012 and 2013
PART A Monthly Premium 40+ quarters of Medicare-covered employment 30 to 39 quarters of coverage Less than 30 quarters of qualifying employment Deductible Daily Coinsurance Hospital days 1 to 60 Hospital Days 61 to 90 More than 90 hospital days (lifetime reserve days) Skilled Nursing Facility (days 21 100) After 100 SNF days PART B Yearly Deductible Monthly Premium Beneficiaries who file with income: $85,000 >$85,000 and $107,000 >$107,000 and $160,000 >$160,000 and $214,000 >$214,000 Joint tax return with income: $170,000 >$170,000 and $214,000 >$214,000 and $320,000 >$320,000 and $428,000 >$428,000 2012 $140 $99.90 2012 2013 Premium-free $248 $451 $1,156 None $289/day $578/day $144.50/day $243 $441 $1,184 None $296/day $592/day $148/day

No Benefits 2013 $147 $104.90

Total monthly premium amount / + Part D premium $104.90 / $0.00 $146.90 / $11.60 $209.80 / $29.90 $272.70 / $48.30 $335.70 / $66.60 Total monthly premium amount / + Part D premium $104.90 / $0.00 $272.70 / $48.30 $335.70 / $66.60

Beneficiaries who are married, but file separate tax returns, with income: $85,000 >$85,000 and $129,000 >$129,000

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GeorgiaCares Referring, Educating And Training News

Program Highlights

Please join DAS GeorgiaCares in welcoming Kimbra D. Butler to our team! Kimbra is the new State SMP Coordinator. She joins us from the American Cancer Society and brings experience with program and volunteer management. Kimbra began Janary 2, 2013. Welcome to GeorgiaCares!

Patricia Whisenhunt has been given a monthly spot in the Augusta Medical Examiner paper. Patricia's articles will be on Medicare fraud, error and abuse along with human interest stories surrounding these areas. The Augusta Medical Examiner is placed in all Augusta hospitals, surrounding businesses and over 500 doctors offices for staff and waiting rooms, as well as nurses stations. Congratulations to the CSRA GeorgiaCares program!

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GeorgiaCares Referring, Educating And Training News

Program Highlights continued

Submitted by: Belinda Jones, GeorgiaCares Coordinator, Southern Crescent AAA Each day GeorgiaCares touches and affects so many peoples lives that sometimes it is good to hear just how much our effort makes an impact. Three Rivers/Southern Crescent GeorgiaCares was looking for an outside the box location to meet seniors and persons with disabilities and located a church that provided food, financial assistance and clothing for the public twice a month. GeorgiaCares partnered with the church to provide a space for counselors to assist beneficiaries with their Medicare and to provide assistance with financial assistance programs, whenever possible. The second day GeorgiaCares was there, a sweet couple, Mr. and Mrs. Peek (pictured here), came in for counseling. This couple has been married for 34 years and the husband is 81 and his wife is 56. They have been reaching out for food and financial assistance for some time because of the high cost of their medications that leaves them with no money for food. The husband is frail and walks with a walker and for this couple to get out is a taxing effort. This couple had no idea of the assistance available to them even though they could have been receiving benefits for 15 years. After a GeorgiaCares counselor explained the benefits available to them and calculated the money they would save, the couple cried in disbelief. GeorgiaCares worked with the husband on applying for QMB, LIS and food stamps. The local office also worked with the wife on getting assistance through Partnership for Prescription Assistance for her medications. After all of the applications were processed, the couple no longer has to pay his Part B and now he has full Medicaid, the wifes medications are at a very low cost and the couple now has food stamps. The story continues because the couple was referred for screening and intake and subsequently, case management. Case management was able to assist with a local church on building them a ramp at no cost and providing the couple with assistive devices to ensure safety in the home. This clearly shows the collaborative effort between SCAAA GeorgiaCares, gateway and case management staffs to ensure all clients are assessed completely through ADRC.

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GeorgiaCares Referring, Educating And Training News

Fraud in the News

Golden Living Nursing Homes Settle Allegations of Substandard Wound Care
U.S. Attorneys OfficeNorthern District of Georgia January 2, 2013 ATLANTAThe United States Attorneys Office announced that the United States and the state of Georgia have reached a settlement with GGNSC Holdings LLC of Plano, Texas, the operator of skilled nursing facilities located in Atlanta, Georgia, to resolve allegations under the False Claims Act and the Georgia State False Medicaid Claims Act that GGNSC provided inadequate and worthless wound care services to residents at two of its Atlanta-area nursing homes. GGNSC operates nursing homes under the Golden Living name. GGNSC has agreed to pay $613,300 to resolve these allegations. The United States share of the settlement is $423,544. Sally Quillian Yates, United States Attorney for the Northern District of Georgia, said, Our office is committed to protecting our most vulnerable citizens and improving the lives of nursing home residents. By failing to provide adequate wound care services to its nursing home residents, Golden Living placed at risk the life and health of individuals who were entrusted to its care. This type of threat to the health and well-being of the elderly in our communities will not be tolerated. Golden Living fraudulently billed Medicaid for nursing services which were substandard and, tragically, resulted in harm to patients, said Attorney General Sam Olens. The nursing home patients depended on Golden Living to provide them with quality wound care services to help them heal, but, instead, were mistreated. We will not stand for such egregious misconduct by a Medicaid provider. Quality of care in nursing homes is a top priority for the Office of Inspector General, said Derrick L. Jackson, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General for the Atlanta region. Health care providers need to know that if they provide worthless services to those most in need, they will pay the price. Mark F. Giuliano, Special Agent in Charge, FBI Atlanta Field Office, stated, The FBI will continue to dedicate its investigative personnel and resources toward such cases of Medicaid and Medicare fraud as was seen here. These federally funded programs provide much needed services but are limited and health care providers that abuse these programs will be held accountable. The government alleges that GGNSC submitted false claims to Medicare, Medicaid, and the Veterans Administration because it provided residents at Golden Living CenterGlenwood (GLCG) and Golden Living CenterDunwoody (GLCD), f/k/a Golden Living CenterNorthside, with inadequate and worthless monitoring, documentation, and prevention and treatment of wounds during the period from January 1, 2006 through May 31, 2011. The claims settled in the civil settlement are allegations only, and there has been no determination of liability. This case was investigated by special agents of the Federal Bureau of Investigation; the U.S. Department of Health & Human Services, Office of Inspector General; the Defense Criminal Investigative Service; and the Georgia Medicaid Fraud Control Unit. The civil settlement was reached by Assistant United States Attorneys Amy Berne and Lena Amanti. For further information please contact the U.S. Attorneys Public Information Office at USAGAN.Pressemails@usdoj.gov or (404) 581-6016. The Internet address for the U.S. Attorneys Office for the Northern District of Georgia is www.justice.gov/usao/gan.

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GeorgiaCares Referring, Educating And Training News

Georgia Department of Human Services Division of Aging Services GeorgiaCares 2 Peachtree Street, NW, 33rd Floor Atlanta, GA 30303 1-866-55AGING (1-866-552-4464), Option 4 Fax: 404-657-5285

GeorgiaCares State Staff: Team Leader/SHIP Coordinator, Erika D. Lawrence SMP Coordinator, Kimbra D. Butler Program Consultant, Donyetta Green Program Consultant, Patsy McDoodle Program Consultant, Christine Williams Business Operations Generalist, Monica Allen