Two weeks ago, Marilyn Tavenner, the current head of the U.S. agency that oversees both the federal health law as well as the Centers for Medicare and Medicaid Services announced she would be leaving her post in February. Her vacancy will mean a temporary administrator will have to be found to fill that vacancy until the White House and Senate Republicans can agree on a successor. If the past is any indication, the odds of those two forces meeting in the middle would be miraculous. Now that some of the attention is being turned from the presidentâs healthcare laws, it provides insight into some of the long-standing problems with Medicare and Medicaid.
Lack of Dental Benefits
Itâs no secret that more than 130 million Americans must pay for their dental care outside their traditional healthcare policies. What some may not know, however, is that millions of Medicare beneficiaries are not covered for dental care. The one exception being itâs an emergency that happens while a patient is already being treated in an inpatient capacity at a hospital.
Then thereâs Medicaid. Dental benefits are often the first to get cut when states need to get their Medicaid budgets in order. Historically, even the federal government has encouraged state Medicaid programs to tinker with their dental care benefits when moneyâs tight. Many may recall in 2011, then-Health & Human Services Secretary Kathleen Sebelius wrote letters to governors saying that limiting or eliminating dental care benefits is an effective way to save Medicaid funds. Naturally, it was controversial.
So now that Tavenner is leaving, should we expect anything different in terms of how these programs work, the quality of service provided and the level of transparency thatâs often lacking, especially when it comes to coverage for the elderly?
Political Problems with Medicaid
We may not know the answers to a lot of questions, but thereâs one thing quite clear: politics play a far bigger role than most believe necessary. In fact, when Tavenner announced her resignation, Senate Majority Leader Mitch McConnell (R KY) wasted no time in releasing a statement that felt more like fair warning to the decision makers. 
It read, in part, âWe now call on the president to nominate someone whose sole focus will be to look out for our nationâs seniors and the many vulnerable Americans who use these programs, and not distract them from that task with Obamacare.â
He might have been referring to a scandal involving Riverside General Hospital in Texas. This investigation resulted in the arrest of several hospital executives, including the hospitalâs CEO, his son and at least five more. The allegations include bilking the Medicaid/Medicare programs of a massive $158 million. CMM halted all payments to the hospital only to have Tavenner instruct deputies to restore the payments. She said she was unaware of the investigation and indictments and instead, chose to blame it on tension âbetween fraud prevention and access to care.â It was the patients who shouldered the worst part of the scandal.
Despite these distractions, both Medicaid and Medicare are invaluable programs that millions rely on. Once you get past those distractions, the scandals and even a few shortcomings in the programs, the value is obvious. If you have questions about Medicaid, the 5 year look back period or any of the programâs benefits and rules, we welcome the opportunity to meet with you. Give us a call today. Our team of estate planning lawyers can help you navigate the sometimes-murky waters.
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