Court Denies All Government Motions in Class Action Seeking Appeal Right for Medicare Beneficiaries on “Observation Status”

_ Court Denies All Government Motions in Class Action Seeking Appeal Right for Medicare Beneficiaries on “Observation Status” - FOR IMMEDIATE RELEASE March 28, 2019 Contact: Matthew Shepard: 202-293-5760, MShepard@MedicareAdvocacy.org In a decision issued on March 27, 2019, a federal judge denied multiple attempts by the federal government to halt a lawsuit by Medicare patients seeking a right to appeal their placement on “outpatient observation status” in hospitals. Alexander v. Azar is a nationwide class action brought by individuals who were forced to pay up to $30,000 for post-hospital skilled nursing facility care because they had been classified as outpatients in observation status, rather than as inpatients. Although care provided to patients on observation status is often indistinguishable from inpatient care, it does not count toward the three-day inpatient hospital stay requirement for Medicare coverage of nursing home care. This leaves beneficiaries with the burden of paying for – or forgoing – extremely costly nursing and rehabilitative care. The opportunity to appeal is critical because of the severe ramifications that can result from the observation status categorization. Class member Ervin Kanefsky of Pennsylvania, for example, a 93-year-old World War II veteran, had to pay approximately $10,000 for nursing home care after being hospitalized for a shoulder fracture for five days. He was initially admitted as an inpatient but later was told that the “powers that be” had changed his status to observation before he was discharged. In a 50-page opinion, the court addressed the government’s motion for summary judgment, motion to “decertify” the class, and motion to dismiss the case. Each motion was denied. Judge Michael P. Shea concluded that the evidence plaintiffs submitted could reasonably establish that physician decisions about whether to classify patients as inpatients are “meaningfully constrained” by criteria set by Medicare. Class members may therefore possess a “property interest” in the Medicare coverage they seek, a necessary component of their constitutional due process claim. The court also concluded that the plaintiffs continue to have standing to bring the case, and that their claims are not moot. The court declined to take the drastic step of decertifying the class, but did modify the class definition to target individuals who have been harmed by observation status in specific ways, and requested further briefing from the parties on that issue. In concluding his opinion, Judge Shea emphasized that the action, now approaching its eighth year, must proceed to trial without delay. Plaintiffs’ lead attorney, Alice Bers of the Center for Medicare Advocacy, welcomed the decision: “People who have paid into Medicare their whole lives, and who risk having to pay thousands of dollars for necessary medical care, deserve a fair process to determine whether they will receive Medicare coverage.” Co-counsel Luke Liss of Wilson Sonsini Goodrich & Rosati, echoed Bers’s observations: “We look forward to showing at trial that these vulnerable patients have a right to appeal to Medicare as matter of constitutional due process.” Co-counsel Regan Bailey of Justice in Aging added, “Hospitals routinely appeal Medicare’s determination of whether a stay was inpatient or observation status. Older adults and people with disabilities should have the same right.” The Center for Medicare Advocacy (http://www.medicareadvocacy.org), established in 1986, is a national nonprofit, nonpartisan law organization that provides education, advocacy, analysis and legal assistance to help older people and people with disabilities obtain fair access to Medicare and quality health care. We focus on the needs of Medicare beneficiaries, people with chronic conditions, and those in need of long-term care. The organization is involved in writing, education, and advocacy of importance to Medicare beneficiaries nationwide. The Center is headquartered in Connecticut and Washington, DC, with offices throughout the country. Center for Medicare Advocacy, Inc. • www.MedicareAdvocacy.org • PO Box 350, Willimantic, CT 06226 • 1025 CT Ave. NW, Washington, DC 20036

Study Finds Home Health Lowers Costs and Readmission Rates Compared to Hospital Care

A recently published study in The American Journal of Accountable Care finds that home health care may result in lower costs and a lower hospital readmission rate for Medicare beneficiaries after emergency room visits. The study, “Improved Cost and Utilization Among Medicare Beneficiaries Dispositioned From the ED to Receive Home Health Care Compared With Inpatient Hospitalization,” notes that total 90-day costs were lower for beneficiaries receiving home health care after an emergency room visit when compared to beneficiaries treated at the hospital ($13,012 and $20,325, respectively). Furthermore, the study finds that beneficiaries receiving home health care had lower readmission rates (23.7%) compared to beneficiaries receiving hospital care (33%).
As part of our Medicare Platform, the Center for Medicare Advocacy (the Center) has long been working to ensure beneficiaries with longer-term, chronic, and/or debilitating conditions have full access to skilled nursing, therapy and related care needed to maintain their conditions or slow decline. The Center’s advocacy efforts include pushing back against bias toward institutional admissions for home care patients, which makes it harder for beneficiaries who avoid hospitalizations to obtain and retain home health care.

• To learn more about Medicare’s home health benefit, visit https://www.medicareadvocacy.org/medicare-info/home-health-care/.
• To read the Center’s ten-part Issue Brief Series: Medicare Home Care Crisis, visit https://www.medicareadvocacy.org/cma-issue-brief-series-medicare-home-health-care-crisis/.

Observation Status: Physicians Challenge the Inspector General

A group of physicians has challenged a recent audit report from the Inspector General for the Department of Health & Human Services[1] that concluded that between 2013 and 2015 Medicare incorrectly paid $84.2 million for skilled nursing facility (SNF) stays for beneficiaries who had not had a prior three-day qualifying inpatient hospital stay.[2] Like the Centers for Medicare & Medicaid Services (CMS), the physicians reject the Inspector General’s recommendations to impose new requirements on hospitals and SNFs to provide additional notices to patients of their outpatient observation status. They base their objections on multiple grounds.
First, the three physicians describe the changes in hospitalization and medical care since Medicare was enacted more than 50 years ago. In 1965, when observation status did not exist, the average hospital length of stay for people over age 65 was 14.2 days; today, the average length of stay is 5.1 days, reduced in large part, they contend, because of changes in medical treatment.
Second, the physicians describe the confusion between the three-day inpatient stay required for Medicare coverage of post-hospital SNF care, and the “two-midnight rule,” established by CMS in 2013 to determine patient status in the hospital.[3] They point to the large percentage of hospital outpatients who are eventually admitted to inpatient status as well as to the Inspector General’s earlier finding that, in 2014, more than 600,000 hospital stays were three nights or longer, but did not include three inpatient days.
The physicians describe the “significant resources” used by hospitals to make decisions about inpatient/outpatient status. More than 40% of job postings for hospital case manager positions are related to patient status. An earlier study found that three hospitals employed an average of 5.1 full-time staff per hospital “just to manage the audit and appeals process related to billing status.”
Adding more paperwork, as the Inspector General proposes, would increase costs but not improve health care.
The physicians recommend synchronizing the two- and three-midnight rules and supporting the Improving Access to Medicare Coverage Act of 2019[4] – federal legislation that would count all midnights in the hospital toward meeting the statutory inpatient requirement.
The Center for Medicare Advocacy agrees with their analysis and with their recommendation to enact federal legislation.
 _________________________
[1] HHS Office of Inspector General, CMS Improperly Paid Millions of Dollars for Skilled Nursing Facility Services When the Medicare 3-Day Inpatient Hospital Stay Requirement Was Not Met, A-05-16-00043 (Feb. 2019), https://oig.hhs.gov/oas/reports/region5/51600043.asp.  The report was discussed at CMS, “Inspector General Report: Medicare Overpaid Skilled Nursing Facilities When Patients Did Not Have Qualifying Inpatient Hospital Stays” (CMA Alert, Feb. 28, 2019), https://www.medicareadvocacy.org/improve-and-expand-medicare-end-the-use-of-outpatient-observation-status-a-billing-issue-that-restricts-needed-care/.
2] Ann M. Sheehy, Charles F.S. Locke, Bradley Flansbaum, “What The Inspector General Gets Wrong About Reforming Observation Hospital Care,” HealthAffairs blog (Mar. 25, 2019), https://www.healthaffairs.org/do/10.1377/hblog20190320.244258/full/.
3] 42 C.F.R. §412.3; CMA, “Observation Status: New Final Rules from CMS Do Not Help Medicare Beneficiaries” (CMA Alert, Aug. 29, 2013),  https://www.medicareadvocacy.org/observation-status-new-final-rules-from-cms-do-not-help-medicare-beneficiaries/.
[4] H.R. 1682, S. 753.

April is National Social Security Month

Posted on March 29, 2019 by Darlynda Bogle, Acting Assistant Deputy Commissioner

It’s National Social Security Month and this year we’re highlighting some of the time-saving features of the my Social Security account. Once you create an account, you’ll see that we already have your work history and secure information to estimate what you could receive once you start collecting benefits.  With your personal my Social Security account, you can also:

• Request a replacement Social Security card;
• Set up or change direct deposit;
• Get a proof of income letter;
• Change your address;
• Check the status of your Social Security application; and
• Get a Social Security 1099 form (SSA-1099).

For over 80 years, Social Security has worked to meet the changing needs of the American public. Today, you can apply for retirement, disability, and Medicare benefits online, as well as take care of other business.

Knowledge is power. You care about your friends’ and family’s future, so encourage them to create a my Social Security account. Celebrate National Social Security Month by learning what you can do online anytime, anywhere.

https://blog.ssa.gov/april-is-national-social-security-month/?utm_campaign=&utm_content=&utm_medium=email&utm_source=govdelivery

Medicare Advantage plans are expanding benefits for long-term care

The options may be limited in 2019 but that's likely to change in 2020 and beyond

Danielle K Roberts | February 22, 2019

Additional pieces of coverage for Medicare Advantage plans may help solve the puzzle of paying for long term care.

If you use Medicare, you probably feel that it does a pretty good job of covering your medical costs. That’s the case for most people, since the government-run insurance plan covers about 80% of outpatient expenses and even more for inpatient expenses.

However, you may not realize that Medicare does not cover one major expense that might be looming for you or your spouse: long-term care. Often, by the time that people realize this, it’s too late or too expensive to pick up long-term care insurance.

And while people with very low incomes can qualify for Medicaid to help them with long-term care expenses, everyone else is left to privately pay for their assisted living centers and nursing home care.

The long-term care gap

About two-thirds of those eligible for Medicare enroll in Original Medicare, or Medicare Parts A and B, which covers hospital and medical costs. Most people who enroll in Original Medicare also opt for a Medicare Part D plan, which covers prescription drugs.

Another option is to choose a Medicare Advantage plan: These plans, offered by private insurers, offer the same coverage as parts A, B and D, and can also include ancillary benefits that Original Medicare does not provide, such as dental, vision and hearing expenses or gym memberships.

Until recently, however, neither the Original Medicare or Part C offered any coverage for long-term care. That changed last year, when the Centers for Medicare and Medicaid Services (CMS) announced that they would begin allowing Medicare Advantage plans to provide some supplemental long-term care services to their members the following year.

The new coverage options

Starting in 2019, Medicare Advantage plans had the option to build in some supplemental benefits that fall into the realm of home and community-based long-term care.

Some of the new long-term care options include:

·         Adult day-care services

·         In-home assistance with custodial care or activities of daily living

·         Respite care benefits for caregivers

·         Home safety modifications like bathroom grab bars, wheelchair ramps, and stair rails

·         Non-emergency transportation services so that members can get to their doctor’s appointments

·         In-home meal delivery

The goal of these newly allowed benefits is to prevent costly hospitalizations and help chronically ill beneficiaries continue living independently for months or even years beyond what they have been able to do in the past. 

Other new benefits

A few other key new benefits were also announced last year:

Better coverage for brand-name drugs: Starting this year, the dreaded “donut hole” for prescription drugs will be eliminated.

When Part D was first introduced in 2006, insurance companies could and did charge members 100% of the cost of their brand name prescription drugs when they reached the coverage gap (or donut hole). The Affordable Care Act changed this and the percentage of the cost that members are responsible for has been slowly falling over the last few years.

This year, members pay no more than 25% of the cost of their brand-name drugs in the gap in 2019.

A new open enrollment period: This year, the Open Enrollment Period from January 1^st to March 31^st each year has been reinstated.

This allows Medicare beneficiaries enrolled in Medicare Advantage plans to either change from one Medicare Advantage plan to another, or they can disenroll from their Medicare Advantage plan and return to Original Medicare and a standalone Part D drug plan. 

So if a beneficiary makes a mistake or finds that they don’t like their plan for any reason, they can make a one-time plan change during this period. It’s a welcome change that may make some beneficiaries feel less hesitant to try an Advantage plan, knowing that they won’t necessarily be locked in.  

Beneficiaries should keep in mind, though, that when they return to Original Medicare from an Advantage plan, they may have to answer health questions and go through medical underwriting in order to add that plan.

The future of long-term care

While the new long-term care benefits will appeal to many people, unfortunately existing plans were initially slow to build in the new benefits this year.

This was likely due to limited time to incorporate the new benefits between the time of the CMS announcement and deadline for plan designs to be submitted to Medicare for 2019 year.

However, given the expected popularity of these changes, it is hopeful that more plans will incorporate some of these supplemental benefits in 2020 and beyond.

As costs of healthcare continue to inflate, it’s likely that more and more beneficiaries living on fixed income will begin to gravitate toward Medicare Advantage plans that offer lower premiums.

These potential new benefits and additional window to change their minds about their plan are certain to increase the number of beneficiaries who choose a Medicare Advantage plan as their coverage in the coming years.

https://considerable.com/medicare-advantage-plans-offer-new-long-term-care-coverage/?utm_campaign=Social%20Media&utm_content=88254577&utm_medium=social&utm_source=linkedin&hss_channel=lis-3Y7QQ-FCpa

Centene CEO: 'The time was right' to buy WellCare for $15 billion

·         "What I've always found [is] when there's a certain amount of uncertainty, there's a challenging environment, that's the time to act," Centene CEO Michael Neidorff says about its acquisition of WellCare.

·         "There was a time this stock was a lot higher ... The time was right and some things don't come back around," he says.

·         We have a lot of time and patience for our long-term investors and we have a lot of them. And I'm willing to bet a year from now we sit down and talk you're going to say to me: 'You did it at the right time," he says.

Tyler Clifford | @_TylerTheTyler_

Published 6:40 PM ET Wed, 27 March 2019  Updated 8:34 PM ET Wed, 27 March 2019CNBC.com

Centene CEO Michael Neidorff on Wednesday told CNBC his company's $15 billion acquisition of WellCare Health Plans "made more sense than I've seen in a long time."

"What I've always found [is] when there's a certain amount of uncertainty, there's a challenging environment, that's the time to act," he told "Mad Money's" Jim Cramer in a one-on-one interview. "That's when it's the best opportunity: Nobody's watching, nobody's expecting it. You take a play that makes sense."

The host noted that investors have begun selling off health care stocks, along with a range of other securities. Health insurer shares also tumbled on Tuesday after the Trump administration began making moves that seek to get rid of the remaining parts of the Affordable Care Act.

WellCare is a government-sponsored managed care company, while Centene services government-sponsored health care programs for uninsured people.

Since early February, shares of WellCare had shed more than $40 before the start of the week, though the stock shot up more than 12 percent during Wednesday's session. Centene's stock is down about 10 percent this year and lost nearly 5 percent on the day.

Cramer asked Neidorff why not wait to make a deal.

"We did wait," the chief responded. "There was a time this stock was a lot higher ... The time was right and some things don't come back around."

Neidorff ran through the number of reasons he likes the deal. Wellcare bolsters Centene's Medicare product, while Centene's technology platform bolsters WellCare's operations, he said. Centene is using preventative technology to reduce costs and "get ahead of the curve," he said.

Neidorff also gave a nod to Apple and its health-focused wearable technologies, which he said is "heading in the right direction."

The merger expands Centene to three new states and strengthens its business in Michigan, he continued. Furthermore, the company now has a presence in all 50 states in one form or another, he said.

"Short-term, I don't think about it. We have a lot of time and patience for our long-term investors and we have a lot of them," Neidorff said. "And I'm willing to bet a year from now we sit down and talk you're going to say to me: 'You did it at the right time.'"

Neidorff also gave his thoughts about the President Donald Trump's declaration that the GOP would be known as "the party of health care."

"Let's wait and see what they try to do first. There are lots of ideas, they have no ideas," he said, highlighting Republicans past plans to "repeal and replace" ACA, also known as Obamacare. "Well they've tried that. I believe that it's gonna hurt them politically if they keep doing that. The last election, I believe people were worried about their health care."

Centene's board officially extended the CEO's contract to 2024, Neidorff said.

https://www.cnbc.com/2019/03/27/centene-ceo-15-billion-wellcare-merger-is-a-play-that-makes-sense.html

New Part D Policies Address Opioid Epidemic

CMS BLOG
https://www.cms.gov/blog/new-part-d-policies-address-opioid-epidemic       
March 28, 2019
By: Kim Brandt, Principal Deputy Administrator for Operations, Centers for Medicare & Medicaid Services

New Part D Policies Address Opioid Epidemic
Early last year, the Centers for Medicare & Medicaid Services (CMS) published a roadmap outlining our efforts to address the national opioid epidemic.  The roadmap details our three-pronged approach, including prevention of new cases of opioid use disorder (OUD), expanding access to treatment for patients who have already developed OUD, and using data from across the country to better target our prevention and treatment activities.
While illicit opioid use is part of the epidemic, prescription opioids provided by physicians can also contribute to the crisis when not used carefully. As Medicare pays for a significant amount of prescription opioids, we strive to ensure appropriate stewardship of these medications that can provide a medical benefit but also carry a risk for our beneficiaries.
As part of our prevention efforts, we’ve introduced new Medicare Part D opioid safety policies to reduce prescription opioid misuse while preserving medically necessary access to these medications. The new opioid policies include improved safety alerts at the pharmacy for Part D beneficiaries who are filling their initial opioid prescription or who are receiving high doses of prescription opioids. Medicare drug plans will perform additional safety checks by sending pharmacies an alert to review certain opioid prescriptions before they are filled. Safety alerts may cover situations like:
• Possible unsafe amounts of opioids. The pharmacist or Medicare drug plan may need to perform a closer safety review of the prescription with the prescribing doctor if a Part D beneficiary receives opioid prescription(s) that exceed a certain amount.
• First prescription fills for opioids. Part D beneficiaries may be limited to a 7-day supply or less for acute pain if they haven’t recently taken opioids (such as within the past 60 days). The limit is based on medical best practices that show that the risk of developing an opioid use disorder increases after 7 days of use. This policy is not intended for current users of prescription opioids.
• Use of opioids and benzodiazepines at the same time. These medications can be dangerous when taken in combination.
If the prescription can’t be filled as written, including the full amount on the prescription, the pharmacist will give the beneficiary a notice explaining how they or their doctor can contact the plan to ask for a “coverage determination” (a decision about whether or not the plan will cover the drug).  The beneficiary or their doctor may also ask the Part D plan for an exception to its rules before the beneficiary goes to the pharmacy, so they know in advance whether the prescription is covered.
It’s important to note that these new policies are not “one size fits all,” and are deliberately tailored to address distinct populations of Medicare Part D prescription opioid users. These interventions do not apply to residents of long-term care facilities, beneficiaries in hospice, palliative, or end-of-life care, and beneficiaries being treated for active cancer-related pain.
The new policies also permit Part D plans to put drug management programs in place to help beneficiaries use opioids and other frequently abused medications safely. If a beneficiary gets opioids from multiple doctors or pharmacies, the beneficiary may need to receive their medications from specific doctors or pharmacies to ensure appropriate care coordination. The plan will send the beneficiary a letter if it will limit their access to these medications under its drug management program.  If so, the beneficiary and their doctor will have the right to appeal.
The new Medicare Part D opioid policies encourage collaboration and care coordination among Medicare drug plans, pharmacies, prescribers, and patients, in order to improve opioid management, prevent opioid misuse, and promote safer prescribing practices. CMS continues to be committed to addressing the opioid crisis and helping our beneficiaries use prescription opioid pain medications more safely.
For more information on the new Part D opioid safety policies, visit https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE18016.pdf.
Training materials including slide decks and tip sheets are also available for:
• Prescribers
• Pharmacists
• Patients
###
Get CMS news at cms.gov/newsroom, sign up for CMS news via email and follow CMS on Twitter CMS Administrator @SeemaCMS, @CMSgov, and @CMSgovPress.

It's wrong to claim Trump budget cuts $845 billion from Medicare

By Jon Greenberg on Tuesday, March 26th, 2019 at 4:58 p.m.

As Joe Biden edges toward officially running for president, he has been taking on President Donald Trump over his plans for U.S. health care programs.

"Did you see the budget that was just introduced?" Biden said in a March 12 speechto International Association of Fire Fighters. "It cuts $845 billion, almost a trillion dollar cut in Medicare. And almost a quarter trillion, $240 billion, in Medicaid. Why? Because of a tax cut for the super wealthy that created a deficit of $1.9 trillion, and now they got to go make somebody pay for it."

Other Democratic presidential candidates and other leaders, including Senate Minority Leader Chuck Schumer, have used the $845 billion figure. But there are a couple of problems with it.

The correct amount is closer to $595 billion — or less, depending on the method used.

And the use of the word "cuts" is debatable, because spending rises steadily from year to year in Trump’s proposed 2019-20 budget. The reduction is from the path Medicare would be on, if nothing changed. Slowing the growth of Medicare is an approach President Barack Obama advanced in his last two budgets. (As Obama’s vice president, those were Biden’s budgets, too.)

Trump’s Medicare budget

The administration would spend $9.398 trillion on Medicare between 2020 and 2029. But the White House predicts that the government would have spent $10.244 trillion in the same time frame. The difference is $846 billion.

But dig deeper, and the numbers change.

First, Trump’s plan takes two hefty pieces of Medicare — extra payments to hospitals that serve a lot of uninsured patients and funds for teaching hospitals — and moves them out of Medicare and into the regular general fund budget. Hospitals still get paid, but the money doesn’t come from the main Medicare trust fund. Spending does fall a bit, but not nearly by as much as the Medicare line items suggest.

Factoring in those dollars — about $250 billion — reduces the total ten-year spending reduction to $595 billion for Medicare.

Some analysts push the number even lower.

The Committee for a Responsible Federal Budget, a think tank that aims to reduce deficits, noted that the administration’s spending plan includes hoped-for savings from changes in medical liability laws, drug regulations and other elements that lie outside of Medicare. Those wouldn’t curtail Medicare services but could result in Medicare cost savings. All told, the committee said the spending reductions could be as low as $515 billion over 10 years.

Less money for providers, not Medicare patients

Most of the proposed changes target payments to hospitals and other providers — and that might not affect the 58 million elderly and disabled people on Medicare.

While hospital trade groups push back, many analysts believe there is room to spend less without hurting recipients.

"In general, these proposals are in areas where there is evidence we pay providers too much," Matthew Fiedler, at the Brookings Institution Center for Health Policy, told us recently. "One big proposal is to make payments site-neutral. Currently, we often pay more for the same service when it’s delivered in a hospital rather than in a doctor’s office, even when there’s no evidence the site of service makes a difference."

Two of the plans along these lines would save a combined $160 billion, according to the Health and Human Services Department.

It’s important to note, though, that not all of the proposed cuts land on providers.

Changes in Medicare’s Part D prescription drug insurance program would directly affect recipients. While one proposal would cap out-of-pocket costs for people with the very highest drug costs, another would expose people below that cost level to higher fees. At the end of the day, the Trump budget reduces payments for people who rely on prescription drugs by $50 billion.

The prescription drug changes might be the clearest example of Medicare cuts in the Trump budget that affect ordinary Americans. The remaining $545 billion potentially could be absorbed by providers.

Reductions vs. cuts

While Democrats criticize Trump for cutting Medicare, Obama regularly offered his own version of steps to rein in the growth of Medicare. In his last budget, Obama proposed trimming spending by about $420 billion over 10 years.  In effect, Biden is chastising Trump for something close to the budget he was part of. (Republicans accused Obama and Democrats of cutting Medicare many times, a claim we never rated better than Half True.)

The reality is, program spending rises every year in Trump’s budget, except for the last one in 2029 (which is mainly a fluke of timing related to when Medicare pays its bills).

So, what’s the difference between a cut and a reduction?

"This issue has been around for decades," said Tricia Neuman, the Kaiser Family Foundation’s Medicare policy director. "It is a proposed reduction relative to the baseline. A cut sounds worse than a reduction, but the effect is the same. If these proposals were adopted, there would be less money paid to providers for specific Medicare services than there would have been."

Our ruling

Biden said Trump’s budget cuts $845 billion, "almost a trillion dollar cut," in Medicare. There are several problems with this.

A more accurate figure lies between $515 billion and $595 billion. Just about all of the reductions target providers and there’s broad agreement that hospitals and other providers could be more efficient. These are reductions against a baseline, but spending rises steadily year to year.

Biden pushed the numbers even further by calling it an "almost a trillion dollar cut."

We rate this claim Mostly False.

https://www.politifact.com/truth-o-meter/statements/2019/mar/26/joe-biden/trump-medicare-budget-cuts-billion/

Tim Conway 'Unable to Make His Own Healthcare Decisions,' Conservatorship Granted to His Wife

Tim Conway is battling dementia as his family settled their differences over his healthcare

HELEN MURPHY

March 27, 2019 01:18 PM

Tim Conway‘s wife and daughter have settled their differences about the actor’s health.

According to court documents obtained by PEOPLE, on Tuesday, Conway’s wife Charlene was appointed conservator of her husband after the court found “clear and convincing evidence” that a conservatorship of Conway was necessary. Charlene was found to be “suitable and qualified” by the court, and Conway consented to her appointment.

According to the filing, Conway, 85, is “unable to make his own healthcare decisions.”

PEOPLE previously reported that the Carol Burnett Show star is suffering from dementia, with his wife and daughter at odds over his medical treatment.

Conway’s daughter Kelly filed court documents in August asking to be appointed the conservator of her father, because she alleged Charlene was “planning to move [Conway] out of the excellent skilled nursing facility he is currently at” and place him into a lesser quality home.

At the time, she claimed her father cannot “properly provide for his personal needs for physical health, food, and clothing” and is “almost entirely unresponsive.”

A week later, Kelly was granted a temporary restraining order, preventing Charlene from moving Conway to a new residence.

Then, in September, according to MyNewsLA, a judge rejected Kelly’s petition for a temporary conservatorship. In October, Charlene said in court papers that she did not believe Conway needed a conservator, but that she should be the one appointed if need be.

Charlene is Conway’s second wife. The veteran actor was previously married to Kelly’s mother Mary Anne Dalton from 1961-78. (In addition to Kelly, they share daughter Jackie and sons Jaime, Tim Jr., Pat, Corey and Shawn.)

The actor starred on McHale’s Navy, co-starred on the 1970s comedy The Carol Burnett Show, acted as the voice of Barnacle Boy on Spongebob Squarepants and even made a special appearance on the second season of 30 Rock, for which he received an Emmy.

He also won a Golden Globe Award for best supporting actor for The Carol Burnett Show, on which he was best known for characters including the Oldest Man and Mr. Tudball.

Conway’s other TV credits include guest appearances on Married… With Children, Mad About You, Glee, Two and a Half Men and Mike & Molly.

https://people.com/tv/tim-conway-conservatorship-wife/?utm_campaign=peoplemag&utm_medium=social&xid=socialflow_facebook_peoplemag&utm_source=facebook.com&fbclid=IwAR3rs2JAmuuOT2d1DXESBq0BVMC2EduxdFG8efduFdsmUzZqtWE6uoZb6s8

In the six months since Arkansas added...

...work requirements to its Medicaid program, just over 18,000 people have lost Medicaid coverage, according to state reports. Overall, Medicaid enrollment in Arkansas has shrunk 7.29% since March 2018, to 836,534 lives.