AAA News & Notes Current Topics
Postings below reviewed and edited July 2, 2008
General Announcement
Older Americans Month
Visit the Administration on Aging (AOA) website for more information about Older Americans Month and other AOA programs.
General Information from the Department of Veterans Affairs
Beware!: Bogus "Representative" Scam -- Veterans Programs
Information from Michael Ennis
Veterans Services Officer, Alameda County
forwarded by the DEPARTMENT OF VETERANS AFFAIRS
Veterans Benefits Administration, Washington, D.C. 20420
Summary: Watch for Unauthorized Representation of Claimants and Unlawful Solicitation of Fees
There have been reports about individuals employed by private companies who claim to help veterans and their dependents apply for VA benefits. Some of these individuals have targeted elderly claimants at assisted living facilities. They give claimants the impression that they are employed by VA.
These individuals lead claimants and facilities to believe they have special knowledge of VA laws and can maximize claimants’ entitlement to VA benefits. Although these individuals work for private companies, they may have job titles that suggest a government connection, e.g., Veterans Benefits Analyst.
Representation
Organizations and individuals that represent claimants for VA benefits are subject to specific statutory and regulatory requirements. Section 5901 of title 38, United States Code, provides, "no individual may act as an agent or attorney in the preparation, presentation, or prosecution of any claim under laws administered by the Secretary [of Veterans Affairs] unless such individual has been recognized for such purposes by the Secretary." While VA can authorize an individual to prepare a benefit claim for a veteran on a one-time basis, this authorization cannot be used a second time without the approval of the VA’s General Counsel.
Solicitation of Fees
Accredited attorneys and agents are allowed to charge fees for representational services they provide after the Board of Veterans' Appeals makes a final decision in a case. VA's regulations provide a narrow exception to the general rule whereby a "disinterested" third-party may pay an accredited attorney or agent for services provided before a final Board decision, and that representation can include the preparation of claims.Some organizations that do not qualify for VA recognition structure their business to receive payment for their services from claimants' private care providers in an effort to avoid criminal penalties.
The care providers typically do not know that these organizations are prohibited by law from preparing claims and charging fees, and are generally unaware of the services provided freely by recognized veterans service organizations.
Recognized Representatives
VA currently recognizes 87 veterans service organizations consisting of 37 national organizations and 50 State and regional organizations for purposes of representing veterans before the Department. All of these organizations provide representation at no cost to the veteran, and by law may not charge any other person for representation before the Department.
You can verify the recognition of organizations and accreditation of individuals on the General Counsel’s web page. Go to www.va.gov. Click on Organizations at the top of the page. Under Staff Organizations, click on General Counsel. When that page opens, click on Recognized Veterans Service Organizations on the left side and then click on Current Bulletin 23-S. This will give you the list of recognized organizations. If you want to see the list of individuals who are accredited through each organization, click on Current Bulletin 2-151. The Office of General Counsel maintains these bulletins and updates them periodically.
Unauthorized representation of claimants and unlawful solicitation of fees is a serious matter. VA is interested in any individual or group that may be engaged in these activities. Veterans should contact their local VA Office of the Inspector General with information regarding anyone who may be violating the law by charging fees.
General Information
From: Community Education Advocate
Legal Assistance for Seniors/HICAP -- 510-839-0393 x 315
ALERT: Beware of Aggressive Marketing Practices for New Medicare Plans
It has come to our attention that insurance agents in Alameda County have been targeting low-income seniors at housing complexes and other locations to market the new Private Fee for Service Plans now available under Medicare Part C, the Medicare Advantage option. While there are no specific regulations against marketing at locations where seniors gather, we would like to warn service coordinators and other senior providers of the concerns for dual eligibles enrolling in such plans.
First of all, Private Fee for Service Plans (PFFS) have no established network of providers. This means that PFFS enrollees must find a doctor and/or hospital that is willing to accept and bill this type of insurance. Insurance brokers claim that all doctors will accept PFFS plans, however, this is not true. We are already aware that Highland Hospital and several doctors are unwilling to accept PFFS plans.
Secondly, if an enrollee is able to find a doctor or hospital who will accept a PFFS plan, they then run the risk that there is no coordination of benefits with Medi-Cal. This means that Medi-Cal will not automatically pay the remaining costs that the plan doesn’t cover. The doctor must be a Medi-Cal provider in order to bill Medi-Cal directly or to waive the costs.
In addition, some PFFS plans may emphasize the “extra benefits” not covered by Medicare such as vision, hearing and dental care. However, dual eligibles may already be entitled to these benefits through Medi-Cal.
For anyone contemplating signing up with one of these plans, it is most important that they make sure their current doctors will accept this type of insurance.
We would like to advise staff members at senior residences to be cautious about allowing insurance brokers and insurance company representatives to speak at your facilities. If you would like to have a HICAP representative speak to your group about ALL the PFFS plans available in Alameda County, or you have questions and need clarification, please do not hesitate to contact HICAP at 510-893-0393, or Jess Strange at jstrange@lashicap.org.
General Announcement
Medicare Information
If you are interested in having someone from Health Insurance Counseling Advocacy (HICAP) come speak to your group about Medicare Advantage plans in Alameda County for 2008, contact Jess at jstrange@lashicap.org or call 510-987-7390, extension 315.
General Announcement
Lavender Seniors Needs Friendly Visitors
GOT FREE TIME? How about spending some of it with an LGBT senior who is homebound and/or needs some company? Lavender Seniors tries to meet the needs of those who would like Friendly Visitors from all over the East Bay. From Fremont to San Pablo, members of our community are isolated and would like to have someone visit them on a regular basis. Some need help grocery shopping or getting to the doctor, some need to get out of the house or the nursing home for lunch or a walk or a movie, and others would be happy just to have someone come to visit and talk with them. Because of the large area we try to cover, it is often difficult to find Friendly Visitors to match with the seniors who would like one.
Additionally, we know that there are many LGBT seniors out there who are isolated and probably closeted in their living situations who could really use a Friendly Visitor. If you are interested in becoming a Friendly Visitor or if you know of someone who would like to have a Friendly Visitor, please contact Pat Cull at the Lavender Seniors' office at 510-667-9655 or by email at pat@lavenderseniors.org.
General Announcement
Senior Center Without Walls
Senior Center Without Walls continues to offer free group activities to homebound seniors throughout the greater Bay Area using telephone conference calls. We expect to have 100 registrants by the end of this session in a couple of weeks, and have capacity to serve many more.
We are now putting together the schedule for the winter/spring session, February through April, and we need your assistance. Our support groups for various challenges to seniors--depression, isolation, etc.--fill up quickly, and we feel we need to add more such groups so that no one is left out.
If you know a qualified individual, someone with experience working with seniors in this way, who might volunteer to facilitate a weekly or bi-weekly group on the telephone for those three months, please ask them to email us at srresources@yahoo.com or call us toll-free at 1-877-797-7299. Facilitators call in toll-free to the groups from home, office, or anywhere it's convenient, and the phone meetings can be scheduled weekdays, evenings, or weekends. We are flexible!
Return to top of page
| 
