Health Law Section will train attorneys to help low-income residents save money on Medicare prescription drug benefits

Issue October 2008 By Kate O’Toole

Free training session will be offered Oct. 29 and via webcast

Thousands of seniors and people with disabilities across the commonwealth are enrolled in the federal Medicare program, but many of them have overlooked the Low Income Subsidy (LIS) for Medicare Part D — a program that helps low-income beneficiaries pay for their prescription drugs.

Diane F. Paulson, an attorney with the Medicare Advocacy Project (MAP) at Greater Boston Legal Services and a former member of the MBA’s Health Law Section Council, observed that despite government outreach, a vast number of recipients who are potentially eligible do not even know about the subsidy. In addition, many low-income Medicare recipients have submitted incomplete applications and never received a response or unsuccessfully attempted to complete the application online.


Paulson’s colleague at MAP, attorney Donna McCormick, noted that without the subsidy, many low-income Medicare beneficiaries simply cannot afford the high costs of the Part D benefit. "Adding an outpatient prescription drug benefit to Medicare should be a plus — and is for some — but not for those who cannot afford their medications even with the benefit," McCormick said. "The subsidy makes the difference."

According to the Centers for Medicare & Medicaid Services (CMS), roughly 20 percent of Medicare recipients who are eligible nationally have not applied for the subsidy. "This percentage represents about 100,000 people in Massachusetts alone," said Patrick Francomano, past co-chair of the General Practice, Solo & Small Firm Section. "That is a tremendous amount of wasted resources for those that need it the most."

"The subsidy application is a 16-question form that takes a little information-gathering. It’s less complicated than the Probate Short Form Financial Statement," explained Susan G. Anderson, immediate past co-chair of the Health Law Section Council. "From a lawyer’s perspective, it’s a simple form, but from a client’s perspective, it may be intimidating."

CMS estimates that the LIS will save an eligible recipient an average of $2,000 a year, and up to $3,600 a year, depending on the number of prescription medications they use. These savings can boost a low-income Medicare beneficiary’s income by about 15 percent. If the MBA helps enroll 100 people in the program this year, their savings could total as much as $360,000.

"These are hard economic times," added Health Law Section Council Co-Chair and Braintree attorney Frank J. Riccio. "Particularly for people on limited incomes who may feel they need to choose between heat, food and paying for their medications."


MBA proposes community-based solution

To address the widespread lack of awareness about this valuable subsidy, the Health Law Section Council, with the help of General Practice, Solo & Small Firm Section leaders, is launching a community service and pro bono project that will assist potentially eligible beneficiaries with their LIS applications. The section council will offer a free training session for interested attorneys to address the basics of the Medicare Part D LIS form, and offer suggestions on how to work with local organizations to help Medicare recipients get the information and assistance they need.

"The hope is that MBA members will work with organizations such as Serving the Health Informa-
tion Needs of Elders and local councils on aging to get the infor-
mation out in their communities, and, as a second step, help some people apply," Anderson said.

Organizers believe the project will be especially appealing to solo practitioners and young lawyers interested in pro bono work. Paulson, who recommended the initiative, described the project as "a good way for attorneys to assist eligible beneficiaries obtaining their LIS, because they can both demystify and assist with the process." She added, "It is also a good way for an attorney to get involved and known in his or her community." The project requires a modest time commitment, yet has the potential to make a substantial impact.

The training session will take place on Wednesday, Oct. 29, from 4 to 6 p.m. at the MBA’s offices at 20 West St. in Boston. The session will also be available via webcast.