June 2023 Newsletter

Legal Lines News

Estate Planning and Elder Law

JUNE 2023

​On March 9, 2023, the Biden administration released a proposed budget for fiscal year 2024, calling for an increase in federal spending along with a series of counterbalancing revenue raisers. The budget was outlined in a document called the “General Explanations of the Administration’s FY2024 Revenue Proposals,” otherwise known as the “Greenbook.” 

The Greenbook is a document created by the US Department of the Treasury to explain the revenue proposals in the President’s budget. The Greenbook also serves as a guide to Congress for tax legislation by describing current laws, proposed changes to those laws, the rationale behind the proposed changes from a policy perspective, and US Department of the Treasury’s revenue projections based upon the proposed changes.

Proposed Changes to How Your Retirement Plan is Managed

The Greenbook outlines proposals on several different topics. One proposal that could directly impact your future financial security is the proposal to prevent excessive accumulations of wealth by high-income taxpayers using tax-favored retirement accounts.

Ways the Administration Wants to Modify the Tax Rules for Certain Trusts

Taxes are not just for individuals—they can impact certain types of trusts as well. Whether a trust pays its own taxes or whether the taxes are paid by the trust’s beneficiaries or the trustmaker depends on several factors.

AFTER THE DIAGNOSIS

People who have been diagnosed with conditions like dementia or diseases like Cancer or Parkinson’s need to be prepared for sustainable, strategic long term care and living plans. Kristine Callahan can help you frame what is necessary to consider for yourself or a loved one who has become disabled or received a chronic or degenerative disease diagnosis at any stage. Her presentation will discuss resources to consider, support to engage, and how to plan for life after receiving a diagnosis that will change your lifestyle.

COME JOIN US ON
Wednesday, May 24th at 12PM
for a 30-minute webinar (via Zoom) discussion
Hosted by Susana Lannik & Presented by Linda LaSalle, MA MT-BC,
Music Therapist- Board Certified

Questions to Consider to Protect
Your Vacation Property

• What Will Happen to Your Vacation Property When You Die?
• What Options Do You Have?
• How Much Will It Cost to Maintain the Property and Can the Beneficiaries Afford It?
• If Giving to More Than One Person, Will They Get Along?

COME JOIN US ON
Tuesday, June 20th at 12PM
1 Hour Seminar

A Personal Note From Susana

This month’s newsletter focuses on the fiscal issues presented in “The Greenbook” a document created by the US Department of the Treasury to explain the revenue proposals in the President’s proposed budget for Fiscal 2024. The items described have a way to go before being enacted as law, but it is a predictor of what may be coming our way! It is not here yet and may be so theoretical that it will never be the way things come to pass. The Greenbook proposals do not necessarily relate to what you and I are experiencing today, or what will even come to pass in the future.

I would like to counter this possibility with an Elder Law reality that is here today and that does relate to costs in a skilled nursing facility. Medicare coverage, in the context of payment for a resident in a skilled nursing facility exists in a limited way for a short period of time. It is still terribly misunderstood—to the detriment of nursing home residents and their families who believe they are “covered” completely because they have Medicare.

First: Medicare is limited, with respect to a recipient residing in a skilled nursing facility, and does not entirely cover long term/custodial care. EVER.

 But for a limited time, you may have Medicare coverage in the circumstance of a need for rehabilitation in a skilled facility that provides it.

Second: The use of the Medicare program within the context of a skilled nursing home setting is dictated by a decision in a case known as Jimmo v. Sebelius. (2013) In this case the court confirmed that Medicare coverage in a skilled nursing facility is to be determined based upon a Medicare beneficiary’s need for skilled care NOT THAT INDIVIDUAL’S POTENTIAL FOR IMPROVEMENT. The Jimmo case confirmed the law that coverage of skilled nursing /therapy is available to anyone who needs those services to MAINTAIN OR SLOW DETERIORATION. Coverage of skilled nursing or therapy is available to that person regardless of the underlying illness, disability or injury.

So, if you or a loved one are told that your Medicare coverage has lapsed because there “has been no improvement” you are being presented with the wrong standard to determine the continuance or cessation of Medicare coverage. You may speak up and cite “Jimmo,” as the standard that the facility should go by is that coverage of skilled nursing or therapy is available to anyone who needs those services to maintain or slow deterioration — regardless of the underlying illness, disability, or injury.”

Third: The Center for Medicare Advocacy has recently updated its fact sheet to outline Medicare beneficiary rights when it comes to Medicare coverage in a skilled nursing facility. This fact sheet may be obtained by requesting it from The Center for Medicare Advocacy, P.O. Box 350, Willamantic, CT 06226, Phone: (860) 456-7790.

I hope this information is helpful to the reader of this note.

Susana

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