Topic

elder abuse

18 petitions

Update posted 2 days ago

Petition to Special Committee on Aging, Daniel R. Levinson, Seema Verma

Protect TVA Retirees & Other Seniors From Misleading Medicare Information

   HELP TVA RETIREES & OTHER SENIORS ACROSS THE U. S. A growing number of U.S. employers are capping their risk of rising health insurance costs by terminating their employer-sponsored Medicare plans and sending their retirees to private Medicare exchanges (PME) to buy replacement coverage. Unfortunately, it appears that some retirees who purchased their new Medicare plans through PMEs may have been subjected to anti-competitive, deceptive, and unfair marketing and advertising tactics. Moreover, these seniors may have paid hyper-inflated prices for their Medicare insurance, while believing they were purchasing their coverage at "competitive" rates. Some believe that this treatment of seniors may be elder abuse. Even a federal agency, the Tennessee Valley Authority (TVA), used a PME to help terminate its retirees’ health insurance plan and transition its retirees to Medicare plans offered by insurers. TVA terminated its retirees’ health plan effective January 1, 2017, and contracted with a PME to help around 15,000 retirees find replacement coverage from individual insurers. The following information is primarily based on TVA's experience with the transition of its retirees to Medicare insurance through a PME.  However, there have been other reports of PME's failing to provide full transparency about rates and other issues similar to those listed below.  Now, there is growing concern in the Medicare oversight community that there may be other PMEs who have used marketing and pricing schemes that may have worked to the disadvantage of our seniors all across the nation, not just in the TVA area. The PME's marketing materials touted a broad selection of plans from major, well-established insurers and stated that those plans were priced competitively. In addition, a PME representative twice told a large group of retirees that the plans offered by the PME could not be purchased elsewhere at lower rates. The PME's promotional material emphasized that the PME would act as retirees' "trusted advisor" by providing "objective and unbiased" advice and providing competitively-priced Medicare plans. In addition, the PME stated that its advice was "free". These commitments were very important to TVA and its retirees.  Unfortunately, it now appears the PME may have failed to deliver on these and other promises for many retirees. In Fall of 2016, TVA retirees started looking at the Medicare Supplement (Medigap) plans offered through the PME and realized that the most popular Medigap plan (Plan G) was 35-67% more expensive than buying it directly from the insurers. The PME offered only 2 insurers for Plan G while there were at least 30 different insurers in the local market, some offering Plan G at substantially lower rates than those offered through the PME. The PME's higher rates could end up costing some retirees an extra $15,000 or more over the next 15 years while providing absolutely no additional benefits. For a family of two, that amounts to $30,000. Retirees continued to complain to TVA about the PME’s rates when, in July 2017, TVA executives challenged the PME about its high rates. The PME eventually admitted to TVA that many of its high-priced plans may carry the look and brand of major, well-established insurers, but the plans are really "separate legal entities" with rates based on different cost structures, resulting in much higher rates. It is important to note that the names of those insurers, their logos, plan descriptors, and plan benefits were used in the marketing and promotions material presented to retirees. TVA executives, just like retirees, were surprised and very concerned to learn about the PME’s use of “separate legal entities” and the significantly higher prices of those plans. Fast forward two years and the above chart compares current rates (effective January 1, 2019) for plans obtained through the PME with rates for plans easily available directly from insurers in the local market.  Clearly, the PME’s rates continue to be, in many cases, substantially more expensive than purchasing directly from the insurers.  The TVA-Humana and TVA-Cigna rates in the chart were obtained from TVA's PME website.  The other rates were obtained from an actuarial consultant that analyzes Medigap plans and rates. Another issue relates to a very basic, but a very important option available to  retirees with no serious pre-existing conditions. Those healthier retirees had absolutely no need for the PME's high-priced "guaranteed issue" plans. Because of their better health, it appears that thousands of TVA retirees would have qualified to purchase any plan (not just guaranteed issue plans) from any insurer in the local market, many at very low rates (check out Aetna's rate in the chart).  It is troubling that, during transition, the PME restricted its offerings for the highly popular Medigap Plan G to just two insurers, both of which had hyper-inflated rates. Intentional or not, that decision appears to be an anti-competitive act by the PME, effectively stymying seniors' access to the most popular Medigap plan. Those with no serious pre-existing health conditions would have easily qualified to purchase any Plan G from any insurer in the local market, but the PME did not notify them of that option. As a group, seniors are more trusting than others, which makes them more vulnerable to misinformation.  There is no doubt many seniors innocently believed they were required to purchase their replacement plans through the PME and also believed that they were purchasing well-established insurers' plans at competitive rates.  We now know that they may have unknowingly and needlessly paid much higher rates for the "separate legal entities" and other plans which included no extra benefits. Some retirees were essentially required to purchase their replacement plans through the PME.  For example, those receiving health care subsidies from TVA stood to lose those subsidies if they did not purchase through the PME. In some cases, the subsidies may have been significant enough to offset the higher cost of the PME's plans.  However, those with very small subsidies, or the thousands of TVA retirees who receive no subsidy,  may have made a very imprudent decision based on false information that could ultimately cost them substantial sums over their remaining years. Also, those retirees who had spouses under age 65 and covered by the TVA employees' health plan were required to purchase their plans through the PME.  Failure of the retiree to purchase replacement coverage through the PME would result in their spouses being denied access to TVA's healthcare plans. For these retirees, purchasing the PME's higher-priced plans may have been the wisest decision for them and their spouses.  However, some retirees believe these requirements were unfair and amounted to "coercion". Based on the foregoing, it appears that the PME:  did not always act as a "trusted advisor", did not always provide "objective and unbiased" advice, did not always provide plans with "competitive" prices, did not advise retirees that they were not required to purchase their plans through the PME did not disclose that healthier retirees had no need for guaranteed issue plans, and failed to disclose its use of high-priced "separate legal entities". Consequently, it appears that many of TVA's retirees were provided with misleading and/or incomplete information about the plans offered through the PME and options for purchasing their plans directly from insurers. Here is the bottom line: Unless they were receiving significant subsidies or had spouses under age 65, why would any fully informed TVA retiree voluntarily purchase the PME's high-priced plans? If other PMEs use similar pricing schemes and marketing tactics, there could already be a very large and growing number of seniors across the nation who innocently purchased their plans thinking they were getting appropriate coverage at a competitive price. Of course, there is no way, based on the limitations of this review, to make a reliable estimate of how many were affected. However, if there is just one, that is one too many. Fortunately for seniors, the Center for Medicare and Medicaid Services (Medicare) has laws that protect against misleading information. By law, if seniors are provided misleading information while selecting their Medicare insurance, they are eligible for a new “open enrollment” opportunity.  The new open enrollment period would allow them to, without penalty, cancel and replace their high-cost plans with lower cost plans that provide the same exact plan benefits! CONCLUSION & RECOMMENDATIONS:  Unless changes are made, it is likely that seniors (not just TVA retirees) all across America may have received misleading information about their Medicare options from PMEs. To prevent this, and to make things right for those who were misled,  Medicare should work collaboratively with state insurance commissions to investigate PMEs' pricing and marketing schemes and, if necessary, take the following actions: Declare an open enrollment period for any seniors who were provided with misleading information.  This would allow, without penalty, replacement of their current plan with a lower cost alternative that includes the same benefits. Ensure employers and PMEs fully disclose to retirees that they are not required to purchase their plans through the PME. Ensure employers and PMEs fully disclose that retirees may be able to find plans in their local market that are less expensive than those offered through the PME.  Determine if PMEs have violated any Federal or State laws.  If it is found that current laws are not sufficient to adequately protect our seniors from these unfair and deceptive practices, then lawmakers should work together to craft and implement laws that will protect our seniors.  

Dan Pitts
1,052 supporters
Started 3 days ago

Petition to The Carlyle Group

Protect nursing homes: Stop cutting nursing home budgets and lining investors' pockets

Under the stewardship of private-equity firm, Carlyle, HRC ManorCare severely neglected nursing home patients before filing for bankruptcy in March. Before Carlyle bought HRC ManorCare, elderly care was in line with U.S. averages. Once Carlyle took over, HRC ManorCare’s 230 locations started to have to do more with less, as the private equity firm trimmed away budgets to benefit investors. Over five years, Carlyle earned $61 million by slashing staff and funds for care. Cuts meant HRC ManorCare locations went without replacing broken equipment, and had as many as 60 patients to every Nurse or Certified Nurses Assistant (CNA). Tell Carlyle that elderly care is more important than lining investor’s pockets. Actions have consequences. One of the wealthiest private-equity firms in the world put 25,000 HRC ManorCare patients in peril for the sake of profits. From 2013-2017, healthcode violations at HRC ManorCare rose by 26%. Violations were centered around neglect, namely: not preventing or treating bedsores, not helping patients with hygiene and eating, not providing care for people with special circumstances - like prosthetics or colonoscopies, and giving patients the wrong medication. All of these issues related to a lack of staff and a lack of funding to replace broken equipment. The accounts of neglect are shocking. A women on her deathbed from uterine cancer was left on her bedpan for so long that she bruised. A disabled man with long dirty fingernails told investigators that he was seldom tended to, and that bedside buttons were rarely staffed - leaving many residents to soil themselves while waiting for help. Another man was given so many opioids that he had to go to the hospital. When one staff member was escorting six patients who couldn’t walk, one of the residents flipped backward out of their wheelchair and had a brain hemorrhage. In another account, a nurse’s aide had to lift a paraplegic woman without a helper, she fell and fractured her hip and hit her head on the floor. These stories are not isolated. They are the price of budget cuts and a desire to increase profits. Tell Carlyle the welfare of nursing home residents is more important than profits. Carlyle’s cuts have resulted in needless suffering to people at the end of their lives. If Carlyle continues to chip away at HRC ManorCare’s budget, lives could be lost. No elderly person should be neglected. Tell Carlyle to stop chipping away at HRC ManorCare.

Campaigns Lab
28 supporters
Update posted 2 months ago

Petition to Guardian Services of Penn, Judge Platt

PA Holds 73 Yr Ol Widow against will in nursing home while family wants her home

UPDATE: My mother is STILL being kept at Sunrise Nursing Home in West Chester Pa . There phone number is 6103994474 against her will. In their own words she “is sharp as a tack” and are considering moving her into a more “INDEPENDENT LIVING UNIT” BUT STILL REFUSE TO LISTEN AND FOLLOW HER WISHES TO LIVE WITH HER FAMILY. Please contact Sunrise and Ashley Kelly to voice your concerns over my moms constitutional rights being violated and the state selling off assets to pay for care she doesn’t need! Dear Sir /MadamHello, my name is Shannon Saucier and I am contacting you to ask for your help on behalf of my 74 year old mother, Phyllis Britton. My mother is a resident of the state of Pennsylvania & has been since 1949. Parkesburg, Pennsylvania is where she & my father built a home, raised my brother, John , and myself  .     In October of 2017, she was pulled over in Salem , Virginia due to driving erratically from dangerously high blood sugar. She was returning home ‪after the burial‬ of my father, William Britton. The state troopers had her transported to Catawba Hospital once they concluded that she was not intoxicated with neither alcohol or drugs and she has been there ever since . Against her will. For over 3 months they have refused to release her regardless of the fact that she is not a threat to herself or others. She has broken no laws in ANY state , she has a support system here in her home state of Pennsylvania, and the financial means to have a visiting nurse if it’s necessary. I also live less than 15 minutes away and have offered to bring her home, to my house.    All to no avail. When my mother was first admitted to Catawba , no one tried to contact myself or my brother , who are her legal next of kin and they have yet to ever call and notify us of anything. Catawba Psychiatric Hospital has also failed to  contact any of my mothers long term physicians  in Pennsylvania for her medical history. Although I was able to have one of her long term physicians to speak to her on the phone & he is of the opinion that she should be released.     Now , on January 5,2018 my mother was transferred to Roanoke Hospital from Catawba Psychiatric Hospital after being found by an aide unresponsive from dangerously low blood sugar. So low in fact , that the machine couldn’t give a read out . Again, Catawba Psychiatric Hospital failed to notify neither my brother or myself about the decline in my mothers health while in their care. Then behind my back I found out that the PA Chester County Department of Aging was urging the VIRGINIA Hospital not to go ahead with their discharge plan. All the while telling me , my mother and my aunt that she would be going home they were working to put her in a facility behind her back with the help of an estranged brother they got named temporary guardian. They have her now in a nursing home here in PA with a room as small as a bathroom with no tv and no window. I’ve been told that if she wants a tv that I would have to purchase it and pay the monthly cable bill- this is a place that is not only getting her social security and pensions that total around $4000/month plus owns assets in the hundreds of thousands. Now that I have had him removed as guardian, an independent guardian has been named and the PA Chester County Department of Aging is not supposed to have any further involvement, I’m asking to have my mothers and my own wish granted that she return home to us to be cared for and no longer have a judge, Social Worker or guardian obstruct her happiness in her golden years. And I can assure you her room will have windows, a tv and whatever else her heart desires instead of warehousing her like a criminal oops I think even criminals get TVs now 

Shannon Britton-McElyea
123 supporters