Minnesota seniors prepare for Medicare plan shift

SEP 18, 2018

MINNEAPOLIS (AP) — An estimated 320,000 seniors across Minnesota will need to change Medicare health plans in the coming months.

Residents with Medicare Cost health plans have to switch because of a federal law eliminating the policy next year in most of the state, The Star Tribune reported.

The 2003 law says Medicare Cost plans cannot be offered in areas with significant competition from Medicare Advantage plans. Congress delayed the law’s implementation until 2019.

Medicare Cost plans will be eliminated in almost 70 Minnesota counties, including Hennepin and Ramsey counties. The plans will still be available in about 20 counties, such as St. Louis County.

About 20 million people in the U.S. are covered by Advantage programs, while only about 630,000 people had Cost plans in June.

“The government is not trying to take away benefits,” said Sean Creighton, a vice president in the policy practice with Avalere, a health care consultancy in Washington, D.C. “What they are trying to do is simplify the administrative structure and have health plans take financial responsibility for managing the health care utilization of enrollees.”

Insurers, government agencies and consumer advocates have begun informing residents about the transition but details of the 2019 coverage options won’t be available until next month.

http://www.marshallindependent.com/news/minnesota-news-apwire/2018/09/minnesota-seniors-prepare-for-medicare-plan-shift/

Site-neutral Medicare cuts to hit academic medical centers hardest

By Virgil Dickson  | September 28, 2018

Academic medical centers in urban areas will be hardest hit by the CMS' proposed site-neutral pay policy for doctor visits, according to a new study commissioned by a health system advocacy organization.

The Integrated Health Care Coalition's analysis estimates that 200 out of 4,000 hospitals that bill Medicare will shoulder 73% of the cuts in the CMS' proposed site-neutral payment rule. Cleveland Clinic will bear a large brunt of the pay cut, with a projected $24 million loss. California's Stanford Health Care with lose $12 million and Evanston (Ill.) Hospital is estimated to take a $11.7 million hit. 

In the 2019 outpatient pay rule, the CMS proposed to expand its site-neutral payment policy. The agency would pay the same for clinic visits regardless of whether they take place in a doctor's office or a hospital's outpatient setting.

The agency said the Social Security Act called for the change because it states the HHS secretary should develop a method for controlling unnecessary volume increases of covered outpatient services.

Total spending on outpatient services has been growing at a rate of roughly 8% per year and it is projected to increase to nearly $75 billion from approximately $70 billion in 2018, according to the CMS. This is approximately twice the total estimated outpatient spending in 2008, it said.

But the agency's rationale doesn't make sense, according to Henry Ford Medical Group CEO Dr. William Conway. His system will lose $7 million in Medicare fee-for service revenue next year if the cut is finalized.

Conway said that any outpatient spending increases in recent years stem from CMS policies that encouraged spikes in use. He cited the agency's decision to move more procedures off the inpatient-only list. The agency increasingly is allowing more joint replacement procedures to take place in outpatient settings, for instance.

The CMS' efforts to move Medicare from a fee-for-service program to value-based care also shifts patients into cheaper, outpatient settings, he said.

"This is an attack on urban academic centers," Conway said of the proposed cut. "We're the ones doing the most innovative care while treating some of the poorest populations."

James Scott, CEO of the reimbursement consulting firm Applied Policy, also took issue with the CMS' reasoning.

"You would expect the amount of outpatient services to increase as the agency allows more services to be performed there," Scott said.

Clinic visits, or checkups, are the most common service billed under the outpatient pay rule. The CMS often pays more for clinic visits in hospital outpatient settings than in physician offices.

The OPPS rule's proposed 60% rate cut would roughly translate to a $760 million hit to hospitals in 2019. The CMS estimates that it was paying approximately $75 to $85 more on average for the same service in hospital outpatient settings compared to physician offices. Beneficiaries were responsible for 20% of that increased cost.

If the proposal is finalized, the American Hospital Association has said it may sue the agency and allege it exceeded its authority and strayed from congressional intent.

"Our comment letter lays out clearly that the CMS was aggressive in interpreting its authority," AHA Vice President Erik Rasmussen told Modern Healthcare, noting that the trade group's next course of action depends on the final rule. "Any time the agency takes more authority than it was given by Congress, it opens them up to legal action."

Conway said he is not optimistic that the cuts can be stopped given the industry's inability to stop the $1.6 billion in 340B cuts that kicked in earlier this year.

"There is a pattern of reckless disregard for industry concern in the federal government today," Conway said. "We're very pessimistic and depressed about the outlook ahead."

A CMS spokesperson did not return a request for comment.

Virgil Dickson reports from Washington on the federal regulatory agencies. His experience before joining Modern Healthcare in 2013 includes serving as the Washington-based correspondent for PRWeek and as an editor/reporter for FDA News. Dickson earned a bachelor's degree from DePaul University in 2007.

http://www.modernhealthcare.com/article/20180928/NEWS/180929877?utm_source=modernhealthcare&utm_medium=email&utm_content=20180928-NEWS-180929877&utm_campaign=dose

Could deep-red Miss. expand Medicaid? 2019 will tell

By Susannah Luthi  | September 22, 2018

GREENVILLE, Miss.—Politically verboten in Mississippi for years, Medicaid expansion keeps simmering in the state Legislature because of one senator. And it could start bubbling up again if next year's governor's race breaks for Democrats.

Medicaid expansion's most ardent champion in the Legislature is Democrat Derrick T. Simmons, one of three state senators representing the gerrymandered Delta districts. Simmons, a native of Greenville in the heart of the Delta, has pushed for expansion against political tides since 2013.

But in those years the state has pulled in the opposite direction. And in 2018, the Division of Medicaid applied to the Trump administration for permission to add work requirements to its Medicaid population. The state already imposes some of the strictest limits in the country.

Now the state government faces a potential shift as GOP Gov. Phil Bryant, a firm expansion opponent, nears the end of his term limit. Mississippi Attorney General Jim Hood, the only Democrat in statewide elected office, is polling in a dead heat with GOP Lt. Gov. Tate Reeves as a likely contender to replace Bryant. Because he has not formally announced his candidacy for the November 2019 election, Hood has not taken a stance on Medicaid expansion. However, close observers think he would likely support it.

That fact, along with an April statewide poll that showed more than 52% of Mississippians support expanding Medicaid, signals that Simmons' proposal now could have a chance.

'They don't understand Medicaid'

The Simmons & Simmons law office sits at the heart of downtown Greenville, where Main Street meets the levee. Family Dollar and Dollar Trees stores and neighborhoods of taped-together houses lie on its outskirts, as well as elegant, pillared old homes shaded by magnolias. The Simmons brothers are trying to revive century-old buildings downtown, but some are crumbling anyway. People with desperate cases who need help or luck or both filter in throughout the day and wait on Naugahyde furniture underneath the massive framed portrait of the brothers standing as mirror images. Derrick, the state senator, wears a bow-tie; Errick, the mayor, wears a straight tie.

The brothers specialize in criminal defense cases. In his public policy work, Derrick Simmons said he prioritizes two things: access to healthcare and education funding—two items that are usually at odds in state budgets. He won his state Senate seat in 2011 and as soon as Obamacare passed in Congress, he set his sights on Medicaid expansion and drafted a bill.

“The Republicans had a supermajority in the Legislature,” Simmons said. “Even before I authored the (expansion) amendment it was known: our Gov. Phil Bryant said he would not support it. Lt. Gov. Tate Reeves said he would not support it. The speaker of the House, Philip Gunn, said he would not even participate.”

Rep. Stephen Holland, a Democratic, said the state Legislature opposes expansion because lawmakers don't understand how Medicaid works.

“The only thing that saves Medicaid among this group is so many of their mothers and grandmothers are in nursing homes funded by Medicaid,” Holland told Modern Healthcare in June. “But they don't understand Medicaid. They talk a big game about how they want to cut back on welfare queens, but they don't do it. It's not right, politically not right, but they don't expend enough energy to understand Medicaid.”

Simmons attributes the opposition to something deeper.

“In Mississippi, we have a dark past, a dark history, and for a lot of people it's subconscious,” he said. “A lot of people, they don't even realize that they use religion when it's convenient. I think some people know that they use it when it is convenient, and I think other people don't. But I believe that as a Christian you would want to help your sister and brother, and I believe that if you are as religious as you purport to be, then Medicaid expansion was it.”

He noted that expansion opponents argue that they don't want to take money and mandates from the federal government.

"But we already take money from the federal government at a rate of 3-to-1," he said. "Look at the farm bill—you don't want to take subsidies, but look at the farm bill and what it does for Mississippi's economy. The only reason you are not critical of that is because of who it's going to.”

The day Derrick Simmons introduced his Medicaid expansion measure in 2013, he walked around the Senate floor asking every single senator to sign on as a co-sponsor. About 15 Republicans told him they wanted to join but said: “You know we can't.”

One big reason, lawmakers and close observers of the Legislature said, was Reeves. The lieutenant governor serves as president of the Senate and can steer legislation. He sent Simmons' bill to two GOP committee chairmen who would kill it on their panels.

Laura Hipp, Reeves' spokesperson, said Reeves was opposed because the state couldn't afford its share of the cost.

“Medicaid in Mississippi accounts for more than $1 billion of the state's $6 billion general fund budget,” she said. “Taxpayers simply could not afford an expansion of Obamacare that would pull limited resources from public schools and public safety and add burdensome regulations on the state's job creators.”

Playing politics

One of the Delta's other state senators, Republican Eugene “Buck” Clarke, chair of the Senate's appropriations committee, said Medicaid expansion “is not even being talked about” in the Legislature now. He, for one, is focused on some prosperity in the Delta which he said lifts some of the pressure off Medicaid.

“I'm really looking at the historic low unemployment numbers and the effect on Medicaid numbers, and we're all kind of excited,” Clarke said.

Unemployment in the Delta has steadily fallen over the past five years, although at 6.8% it is still more than a percentage higher than the statewide rate.

Clarke directs his Medicaid efforts to pilot programs, like a project by the not-for-profit Delta Health Alliance to curb pre-term births and diabetes among Medicaid enrollees.

“With the pilot programs and we're in uncharted territory with this many people working in the state—I hate to sound like I'm salivating over new revenue coming in—but it's encouraging,” Clarke said.

Roy Mitchell is executive director of the Mississippi Health Advocacy Program in Jackson which helps people who don't qualify for Medicaid or who are otherwise falling through the cracks to get care. He called the idea that people can afford health coverage once they start working a myth because few employers offer it, particularly in the Delta.

“When they do offer it, the wages are so low that it doesn't assume people can afford it,” Mitchell said. “In terms of adult coverage, we found it common for counties to have a 30% uninsured rate for adults, and 10% uninsured rate for children.”

In the long shot chance that the state sees a political turnover in the near future, it's unclear how the healthcare industry—poised to reap financial gain from expansion—will respond. An early lobbying effort by hospitals resulted in a shakeup of the state hospital association, according to several observers of Mississippi politics, and hospital executives don't want to talk about it.

“They took a back seat to lobbying, even though if you would talk to individual hospitals, the rural hospitals would hurt more without it,” Simmons said of the state's hospitals. “It was the political retaliation that people have to endure in Mississippi. If you don't have a level of security or independence, it's easy for you to feel like the retaliation is going to get to you.”

Mitchell said the hospitals' unwillingness to take a stance has sunk them in the public's approval.

“It is frustrating to me,” he added. “I don't really understand: Mississippians vote against their own interests, but if we take it to another level, the hospitals vote against their own interests. The hospital association is dominated by the urban (provider) market, but lack of expansion hurts all of them. The reputation hospitals and doctors have in the community—it's well-earned.”

Susannah Luthi covers health policy and politics in Congress for Modern Healthcare. Most recently, Luthi covered health reform and the Affordable Care Act exchanges for Inside Health Policy. She returned to journalism from a stint abroad exporting vanilla in Polynesia. She has a bachelor’s degree in Classics and journalism from Hillsdale College in Michigan and a master’s in professional writing from the University of Southern California.

http://www.modernhealthcare.com/article/20180922/NEWS/180929960?utm_source=modernhealthcare&utm_medium=email&utm_content=20180922-NEWS-180929960&utm_campaign=dose

Medicare Advantage premiums hit three-year low

By Virgil Dickson  | September 28, 2018

Medicare Advantage plans' average monthly premium will be $28 next year, marking the lowest charges in the last three years, according to the CMS.

On average, Medicare Advantage premiums will decrease by 6% from $29.81 per month in 2018. Nearly 83% of Medicare Advantage enrollees who stay in their current plan will have the same or lower premium in 2019, according to a report released Friday.

"The steps that the Trump administration has taken to improve and drive competition in Medicare Advantage means more savings, more benefits and lower costs for seniors," CMS Administrator Seema Verma said in a statement.

Premiums are decreasing as the number of coverage options increase. There will 600 additional MA plans next year. More than 91% of people with Medicare will have access to 10 or more Medicare Advantage plans, compared to nearly 86% in 2018.

Medicare Advantage enrollment is projected to increase to an all-time highof 22.6 million, or more than 36% of Medicare beneficiaries, in 2019. That's an 11.5% increase compared with 2018, which had enrollment of 20.2 million.

The findings come one day after HHS' Office of Inspector General alleged that MA plans may be denying claims to boost their profits. They cited the high overturn rate of pre-authorization and payment denials once challenged.

CMS has committed to increasing oversight to address the issues raised but did not provide details to the watchdog agency.

Medicare open enrollment runs from Oct. 15 to Dec. 7.

Virgil Dickson reports from Washington on the federal regulatory agencies. His experience before joining Modern Healthcare in 2013 includes serving as the Washington-based correspondent for PRWeek and as an editor/reporter for FDA News. Dickson earned a bachelor's degree from DePaul University in 2007.

http://www.modernhealthcare.com/article/20180928/NEWS/180929880?utm_source=modernhealthcare&utm_medium=email&utm_content=20180928-NEWS-180929880&utm_campaign=dose

Getting to Self-Sufficiency by Tackling Health and Financial Stability

September 28, 2018

By: Judy Sarasohn, HHS (Public Affairs)

Summary: 

Goodwill NFP in Indiana is one of many initiatives across the nation funded by HHS to help low-income families become healthy and financially self-sufficient.

Consistent with President Trump’s Executive Order on Reducing Poverty in America by Promoting Opportunity and Economic Mobility,  HHS’s Strategic Plan sets goals for HHS to encourage self-sufficiency and personal responsibility, and eliminate barriers to economic opportunity (Objective 3.1) and to support strong families and healthy marriage, and prepare children and youth for healthy, productive lives (Objective 3.3). This blog is part of the Self-Sufficiency Series: Solutions from the Field, which profiles local programs from across the country finding solutions to accomplish these goals.

Collaborations across the nation receive support from the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) of HHS’s Health Resources and Services Administration (HRSA). The various initiatives aim to meet the department’s Strategic Plan goals to encourage self-sufficiency and personal responsibility, while improving health outcomes for individuals like Dianna Tolentino, and her husband Luis. 

These two Indiana residents were expecting their first child, and were just getting by, both working low-level jobs at fast food restaurants. But a referral by her doctor to the Nurse-Family Partnership (NFP) has changed the course of her family’s future. NFP and Goodwill of Central and Southern Indiana - PDF have joined hands to improve the health of low-income, first-time mothers and their babies and to strengthen the economic stability of their families. 

This particular MIECHV-funded program, Goodwill NFP, is one of many efforts across the nation that receives support from MIECHV. The various initiatives aim to meet the department’s Strategic Plan goals to encourage self-sufficiency and personal responsibility, while improving health outcomes. NFP is a national program that has a presence in 42 states and currently serves more than 34,000 families. Goodwill implements the Goodwill NFP program in 30 counties in Indiana.

Under this particular MIECHV-funded program, Goodwill NFP focuses on education and employment. Moms—and dads—lacking high school diplomas can enroll in one of Goodwill’s adult tuition-free high schools—The Excel Center and receive support through with tutors, child care, internships and life coaches, all at no cost. Goodwill’s in-house TalentSource is available to help program participants find higher-wage jobs.

HHS has set a goal to prepare children for healthy, productive lives, and programs like this contribute to this goal. “Education is one of the biggest social determinants of stability and good health,” said Betsy Delgado, vice president, mission and education initiatives, of Goodwill of Central and Southern Indiana, who told me, “We know children will do better if they are children of solid families.”

Tolentino Family: Goodwill NFP graduate Dianna with husband Luis, son Drakeo and daughter Rain. Photo courtesy of Goodwill

Under this MIECHV-funded program, Goodwill NFP also pairs first-time mothers-to-be with a nurse who visits them at their home and tracks their health and their child’s development to the age of 2. Abby O’Connor, an RN who was Dianna’s nurse, monitored her vital signs, made sure she made her pre-natal care appointments, advised her on baby care, and generally taught her how to  have a healthy pregnancy. Dianna and Abby told me that they talked a lot about Dianna’s goals for herself and her family.  Fathers and other family members can also participate, if the mother wants them to. Abby said Luis became involved in the home visits and attended The Excel Center, earning his high school diploma and a clinical medical assistant certification.

“Our nurses become a big part of a support system that young, first-time mothers often don’t have,” Abby said. “We help moms be their best self.” 

According to Goodwill, only 45 percent of the participants were working before joining the program, while more than 68 percent were working by the time their child had turned 2 years old. Last year, within a year of enrollment, 66 percent of households had an increase in income and benefits. Goodwill program data also show that in 2017, 91.3 percent of the moms who participated in the initiative delivered full-term; 89.5 percent of the babies had a normal birth weight and nearly 100 percent of the women quit or reduced tobacco use before their child’s birth.  Goodwill NFP said these outcomes help set children up for healthy lives, as HHS works every day to do.

Dianna credits Abby’s care and their close relationship with her successful pregnancy. When Abby suspected complications, she made sure Dianna went to her doctor, who determined that she had a condition that would lead to a significantly early delivery, and without medical intervention would endanger both mother and baby.

They now have a healthy daughter and son. And Dianna credits Goodwill NFP for helping her family become more financially stable. Dianna said she now has a job in administration at The Excel Center and is working with a Goodwill coach to increase her financial literacy. “I have no credit history and I didn’t know how to budget,” she explained. Luis has the option of using his certification for a job at a hospital, but he’s working as a chef, which is his long-term goal, Dianna said.

Every day, MIECHV-funded programs help couples like Dianna and Luis move toward self-sufficient and healthy families.

“Without this help [from Goodwill and NFP], it would have been rough. There was not much wiggle room in our lives,” Dianna said. “I look back and can’t imagine how different our lives would have been without NFP and Goodwill. It’s moved us from barely scraping by to becoming a thriving family.”

This effort is just one of countless examples of MIECHV-funded programs across the country working to eliminate barriers to economic opportunity and prepare children for healthy, productive lives. HRSA announced on September 27 approximately $361 million in funding to Indiana and 55 other states, territories and nonprofit organizations through the MIECHV Program. These funds support communities providing voluntary, evidence-based home visiting services to women during pregnancy and to parents with young children up to kindergarten entry.

https://www.hhs.gov/blog/2018/09/28/getting-to-self-sufficiency-by-tackling-health-and-financial-stability.html

September 28, 2018

New Living Well Grants Awarded ACL awarded five new grants totaling $1.96 million over five years (or $392,000 for each grantee) to help develop and test model approaches for enhancing the quality, effectiveness, and monitoring of home and community-based services (HCBS) for people with developmental disabilities. The projects funded by the new grants began on September 30, 2018.  The Curators of the University of Missouri on behalf of University of Missouri-Kansas City; Indiana Family and Social Services Administration; The Governor's Council on Disabilities and Special Education--Alaska; The Wisconsin Board for People with Developmental Disabilities; and The Regents of the University of Idaho These Model Approaches for Living Well grants, awarded as Projects of National Significance by ACL’s Administration on Intellectual and Developmental Disabilities, are focused on building the capacity of HCBS systems and enhancing community monitoring to prevent abuse, neglect, and exploitation. The grants seek to strengthen HCBS systems and promote the health, safety, independence, and participation of people with disabilities. Grantees will work with a broad coalition of state stakeholders to: Support professionals working directly with people with disabilities; Promote the leadership of self-advocates and families; Promote the use of evidence-based and promising practices such as supportive decision making, person-centered planning, and competitive integrated employment; Address abuse and rights violations in the HCBS delivery system; and Increase the capacity of states to provide HCBS in integrated settings. Additionally, a new training and technical assistance (T&TA) contract was awarded to Mission Analytics for supporting the design and development of effective T&TA to these new Living Well grantees and the three grantees awarded last year to enhance outcomes and disseminate project results and promising practices. *** University Centers for Excellent in Developmental Disabilities Education, Research & Service (UCEDDs) are a nationwide network of independent but interlinked centers, representing an expansive national resource for addressing issues, finding solutions, and advancing research related to the needs of individuals with developmental disabilities and their families. Projects of National Significance focus on the most pressing issues affecting people with developmental disabilities and their families. Through the projects, AIDD supports the development of national and state policy and awards grants and contracts that enhance the independence, productivity, inclusion, and integration of people with developmental disabilities. Back to top

July 2018 monthly report on state Medicaid and Children's Health Insurance Program (CHIP) eligibility and enrollment data.

View in browser | Distributed by Center for Medicaid and CHIP Services (CMCS) Today the Centers for Medicare & Medicaid Services (CMS) released the July 2018 monthly report on state Medicaid and Children's Health Insurance Program (CHIP) eligibility and enrollment data. The full report is available on Medicaid.gov at https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/report-highlights/index.html

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Stay connected with Medicaid.gov and CMS:

September 28, 2018

ACL Webinars on Innovative Nutrition Projects Join the National Resource Center on Nutrition & Aging for two webinars in October about Innovations in Nutrition Programs and Services grants. In 2017 ACL issued a funding opportunity for the Innovations in Nutrition Programs and Services grants for supporting systematic testing and documentation of innovative and promising practices that would enhance the quality, effectiveness, and proven outcomes of nutrition services and programs within the aging services network. A cohort of six grantees from across the nation was selected to receive this funding.  Participants will hear from each of these ACL grantees about their Innovative Nutrition projects in action across the country. Participants will also receive recommendations for potential replication in their own communities, as well as lessons learned from implementing this work. Register for Innovative Projects for Nutrition Programs and Services Part 1 on October 17, 2:30 pm - 4:30 pm EDT. Register for Innovative Projects for Nutrition Programs and Services Part 2 on October 24, 2:30 pm - 4:30 pm EDT. Back to top

How advisers can help cancer patients tackle financial distress

The Foundation for Financial Planning is calling for a national response to the potential financial ruin of families fighting the disease through the Pro Bono for Cancer Campaign

Sep 21, 2018 @ 10:12 am

By Jon Dauphiné

I'll never forget the shock when my brother-in-law, Billy — an avid athlete and outdoorsman — visited a doctor for his heartburn, only to learn he had stage 4 esophageal cancer. He fought the disease hard, but it claimed him eight months later, leaving behind my sister and teenage nieces.

An attorney, Billy had always handled the family finances, and my sister scrambled to understand what she needed to do while managing the flood of incoming medical bills. She was lucky enough to have the resources to access a good financial planner, ensuring a measure of economic stability to weather the emotional and financial storm. But many Americans lack access to a planner, and for them a cancer diagnosis can trigger a financial catastrophe that has negative consequences on their emotional and physical health.

Researchers have found that financial issues are the second most frequent source of distress identified by cancer patients. They've even coined a name for this: "Cancer-Related Financial Toxicity" (CRFT), manifested by a mix of severe economic stress, depression and anxiety that can worsen the underlying health condition. Even with private health insurance or coverage through Medicare or Medicaid, families are at substantial risk of a financial disaster. They experience not only a major increase in daily expenses but often a significant loss of income due to the patient's and caregiver's inability to maintain full-time work. The impact on patients can be grim:

• 38% postpone or do not fill drug prescriptions to reduce costs

• 37% cut back on groceries

• 36% deplete their savings

• 24% borrow against their retirement funds

One study found cancer patients are nearly three times more likely to go bankrupt than people of a similar age without cancer. Another found that cancer patients in bankruptcy were 80% more likely to die from any cause than other people with cancer.

Objective, expert financial advice and planning can benefit these patients. Scott Ramsey, a health economist, researcher and physician at the Fred Hutchinson Cancer Center in Seattle, recommended in a Washington Post interview that all patients diagnosed with cancer be assessed for financial risk — and for those deemed at-risk, that health-care providers "be very aggressive with getting them to financial planning [and] to patient assistance programs to reduce their likelihood of having financial devastation."

The Foundation for Financial Planning is helping to drive a national response to the problem through the Pro Bono for Cancer Campaign, our signature initiative to develop and support efforts around the country to connect cancer patients and their families to free, quality financial advice. We've raised significant seed funding, allocated more than $445,000 in grants and partnered with other nonprofits such as Family Reach, which specializes in helping people with cancer across the nation, and the Financial Planning Association, which is working to recruit CFP professionals to volunteer for the effort. We've funded an infrastructure — spearheaded by Family Reach — that includes a special online CFP training (offering CE credit) and a digital platform for connecting planners to patients.

Since the effort launched earlier this year, dozens of CFP volunteers have been matched to families in need. As the program grows, we hope to reach many hundreds of low- to middle-income families to assist them with pro bono financial planning, with most of the engagements conducted virtually so we can better match the supply of patients to available volunteers. Outcomes will be measured and reported by some of the leading researchers on CRFT, enabling us to refine the program over time.

To meet our ambitious goals, we need help from the financial planning community. Your time and support can assist people like Mike and Leslie Longo, whose comfortable middle-class life with their three kids was upended when Mike received a diagnosis of a rare form of non-Hodgkin lymphoma at just 32 years old. Mike has faced grueling treatment and relapses, and his family has struggled to pay basic expenses, including their mortgage and utility bills. As part of our Pro Bono for Cancer effort, the Longos have been connected to a volunteer financial planner who is helping them manage their financial challenges, serving as a trusted adviser as they chart their future path.

Thousands of families like the Longos are currently struggling to navigate the financial toxicity of cancer on their own, providing the financial planning profession with an extraordinary opportunity to help. Will you join us? Find out how you can pitch in by visiting ProBono4Cancer.org.

Jon Dauphiné is chief executive of the Foundation for Financial Planning.

https://www.investmentnews.com/article/20180921/BLOG09/180929978/how-advisers-can-help-cancer-patients-tackle-financial-distress

Determining if a message from Social Security is a scam

Hint: Pay attention to emails, ignore phone calls

Sep 19, 2018 @ 11:32 am

By Mary Beth Franklin  

A financial adviser contacted me recently to ask if the email he received from the Social Security Administration reminding him to review his estimated benefits statement online was valid.

"Does Social Security send out these types of emails, or is it a scam?" he asked.

Coincidently, I received a similar email this week reminding me to review my online statement to ensure that my earnings record is correct and to see my latest benefits estimate.

We can all breathe easier. The Social Security email is valid, and it's an excellent idea to review your benefits statement at least once a year. While it is your employer's responsibility to report your earnings each year, it is up to you to make sure they are accurate. If your earnings record is wrong, it could affect your future benefits.

But the Federal Trade Commission recently​ issued a warning to ignore phone calls from official-sounding callers who tell you your Social Security number has been suspended due to fraudulent activity and then ask you for your personal information to reactive your account. It's a scam. Your Social Security number is never suspended.

To review your estimated benefits statement, log on to the Social Security website and sign on to your account. Warning: Passwords expire every six months, so you may need to reset it. You also must have a second method to verify your identity — either a cell phone or an email address — where you can receive a security code to authenticate your account.

The Social Security statement is a treasure trove of financial information. Page 2 of the four-page document lists your estimated Social Security benefits at age 62 (if you are younger than that), at your full retirement age and at age 70. The estimates do not include cost-of-living adjustments that will be applied to your future benefits once you claim them, meaning your actual benefits could be larger.

The retirement benefit estimate assumes you will continue to work and make about the same as you did in 2017. Generally, the older you are and the closer you are to retirement, the more accurate the retirement estimates will be.

For example, my estimated retirement benefit at full retirement age increased by about $800 per year from last year's statement because I continue to work and pay taxes. My latest year of earnings replaced one of the earlier, lower-earning years used in the 35-year calculation used to determine future benefits. My husband's benefit estimate remains the same as last year. Although he has reached full retirement age, he has not yet claimed benefits, and his part-time earnings over the past few years have not boosted his average lifetime earnings.

Advisers often ask me what happens to a client's benefit if he retires now but doesn't plan to claim Social Security until later. The Social Security Administration's Retirement Estimator can calculate personalized benefit estimates in such cases. If you have clients who are public employees who have pensions based on work where they did not pay FICA taxes and who also worked long enough in the private sector to earn a Social Security benefit, be aware their future benefit could be smaller than their estimated benefit statement indicates.

The statement also includes an estimate of your benefit if you became disabled right now and how much your spouse and any eligible minor child could receive in survivor benefits if you were to die this year.

Pages 2 and 3 list your year-by-year lifetime earnings up to the maximum taxable wage base subject to Social Security taxes and total wages if above that annual amount subject to Medicare taxes. It serves as a timeline of your lifetime earnings and can help you map out plans for clients' retirement savings and future income needs.

You and your employer each paid 6.2% of your earnings up to the taxable wage base of $128,400 in 2018. If you are self-employed, like me, you pay the combined employee and employer amount, which is 12.4%, up to the maximum taxable wage base. In addition, you and your employer each pay 1.45% (2.9% for self-employed) on all of your wages, including those above the taxable wage base, in Medicare taxes. High-income workers ($200,000 single/$250,000 married filing jointly) also pay 0.9% in Medicare taxes on earnings above those thresholds.

Page 3 also lists the total amount in Social Security and Medicare taxes that you and your employers have paid over your entire career. That cumulative Social Security tax should serve as a stark reminder of why you should try to maximize your Social Security benefits and coordinate your claiming strategy with your spouse if you are married.

https://www.investmentnews.com/article/20180919/BLOG05/180919916/determining-if-a-message-from-social-security-is-a-scam