New Arizona Law Helps Protect Against Excessive Surprise (out-of-network) Medical Billings.

Surprise billings from medical providers who are out of the insurer’s network happen often and are a very unpleasant experience for insured patients.  This often happens when a specialist is summoned unexpectedly by an in-network provider on a medical case and can result in substantial medical bills that are in excess of what insurers will reimburse under the patient’s health plan.

A new law in Arizona seeks to protect patients by providing them with a new dispute resolution system for surprise bills that are at least $1,000 above the combined patient cost-sharing and insurer’s allowable reimbursement. The dispute resolution process includes a pre-arbitration settlement conference and mandatory arbitration to provide a final determination of the matter if it is not settled beforehand.  This will only occur if the patient has exhausted appeals with the insurer. The arbitration must occur in the county where treatment is rendered and may be by phone. The process is designed to take only a few months and there are penalties for noncooperation by either party.

This process, though falling short of limiting the practice of surprise billing like several other states have, is a significant step forward in protecting patients from this very unpleasant surprise.






Most of us feel quite relieved when we get our estate planning done, particularly when it comes to naming someone to make decisions for us when we cannot (health care proxy) or providing advance directives concerning our last illness or injury (often referred to as a living will).

The American Bar Association Commission on Law and Aging has developed a smartphone app that allows users to store and distribute their living will or health care proxy. The app is called “My Health Care Wishes.”

How Does It Work?

The app makes advance directives easily accessible when they are actually needed. The app enables individuals, and their family members to store their own, and each other’s documents and important medical histories on their smartphones.  There can be a struggle to find needed information when a parent has a medical emergency and children are often scattered around the country, as is often the case. Distributing the information to each child’s phone would allow quick access to the information and any person with the information could email the information to the medical provider who needs it in real time, saving valuable time in the event of a crisis.

What Else Do I Need To Know?

Advance directives, such as a Living Will or Health Care Power of Attorney, legally authorize another person to make health care decisions if an individual loses the ability to make his own decisions. It is important for everyone to create and sign these directives and to be certain that their appointed agents know where to find the documents when needed. More info about the app can be found at

Questions? Contact us for more information.



Preventing Identity Theft After the Death of a Loved One

For a loved one after death to become a victim of identity theft is the last thing any of us would ever expect to happen. Unfortunately it is a regular occurrence. There are some very important steps we all can take to prevent this from happening:

  • Do not include the birth date, last address or most recent job in the deceased loved one’s obituary.
  • Make sure someone is in the deceased loved one’s home during the published visitation and funeral times, to prevent a burglary/ theft of documents with sensitive personal information.
  • Make sure each of the credit reporting bureaus gets a copy of the death certificate and ask each to add a “deceased alert,” which will freeze the credit file.

Equifax: PO Box 740241, Atlanta, GA 30374

Experian: PO Box 9701, Allen, TX 75013

TransUnion: PO Box 2000, Chester, PA 19022

  • About one month after the loved one’s death, review your loved one’s credit report at to ensure there is no suspicious activity. You may want to do this once a month for one year after the death since it takes that long for an account with a deceased notation to be removed from a credit report.
  • Make sure that your funeral director has notified Social Security about the death of your loved one. You may also want to advise the IRS by calling 800-829-1040 to prevent someone from filing a tax return and claiming a refund in the name of the deceased loved one.
  • Be sure to keep copies of any documentation you provide to these agencies, just in case a follow-up is needed


Dad is becoming very forgetful – What Should I Do?

Q.           My father is becoming very forgetful about things he would normally remember. I’m worried he could be coming down with Alzheimer’s disease or other dementia. What should I do?

A.            An obvious first step is to have Dad checked out by a qualified physician. The doctor can determine what, if anything is actually wrong and recommend treatment. If the doctor’s diagnosis is dementia further legal steps to provide Dad with adequate legal protections are necessary.

It is important to have the doctor spell out, as clearly as possible; exactly what Dad is capable of doing from a decision-making standpoint when the diagnosis is made. For example, can Dad identify and understand the extent of the property he owns and who his heirs are? Is he capable of understanding the nature of a transaction sufficient to enter into a contract? Can he identify those who he trusts enough to manage his affairs in order to authorize them to do so?

If the answer to any of the above questions is “yes” then it is imperative to consult an elder and estate planning attorney in order to put Dad’s legal affairs in order with documents such as Powers of Attorney for financial and medical affairs, wills, trusts, and any other documents which apply to his particular circumstances. By doing this, we can keep Dad’s life private and reduce legal fees and court costs.

If the answer to the any of those questions is “no” it may be necessary to go into probate court and petition for a Guardianship and Conservatorship in order to take over management of Dad’s personal and financial affairs.  This is an expensive, public process that requires ongoing court supervision. This scenario will often occur once a dementia patient progresses to later stages and no longer has the capacity to enter into legal documents that would eliminate the need for a guardianship or conservatorship. This is another reason for consulting a physician and an elder and estate planning attorney as early as possible. It is strongly recommended to have legal documents in place that provide others with authority to act on one’s behalf well before dementia or any other incapacitating condition rears its ugly head.


Questions?  Contact us today for a consultation.




Unwary seniors are increasingly victimized by others regarding their identity and financial assets.

This often occurs when a credit or ATM/Debit card is lost or stolen. Seniors often delay reporting any missing or stolen credit or ATM/Debit cards. These events should be reported immediately to prevent substantial financial loss.

When a credit card is involved you can report the problem before any charges are actually paid and dispute any improper charges posted against the card. With an ATM/Debit card the theft/loss event becomes much more serious. The general rules for ATM/Debit cards are as follows and may vary by card provider:

  • If ATM/debit card is reported lost/missing before being used again then no loss; $0
  • Within 2 business days after lost/missing, loss is limited to $50
  • More than 2 days after lost/missing, loss is limited to $500
  • More than 60 days after lost/missing, unlimited liability (whatever is in the bank account and possibly linked accounts)
  • The best way to limit risk of loss is to confine the use of it as an ATM/debit card as much as possible, or use it exclusively as a credit card instead. Many credit cards have applications that will alert to charges almost instantly.
  • Questions?  Contact us today for a consultation.

Aging Parents and Financially Troubled Children

Q.           I am retired and my adult child is borrowing money from me. There is nothing in writing and I am worried about getting paid back. I also want to be fair to my other children when I die. How do I handle these issues?

A.            This is a common problem in a sluggish economy that is forcing adult children to turn to their aging parents for financial assistance.

A written promissory note should always be used when loaning money to a family member, including a child. While it may seem impersonal and cause some tension, it imposes legal responsibility and, in some cases, dealing with personal responsibility is exactly what the child needs. This also makes sense because an aging parent has taken care of the kids. It’s time to worry about oneself. An aging parent has a retirement and increasing healthcare needs to finance. Children who are forced to borrow money are certainly in no position to help.

In this context the promissory note itself becomes very important. The population is aging. More and more of us will eventually end up in a nursing home and it will need to be financed. In Michigan, nursing home cost in 2015 is more than $8,000 per month on average. Typically, since Medicare doesn’t provide coverage, a person must apply for Medicaid in order to afford this care. The Medicaid rules regarding loans by applicants are strict, particularly regarding repayment terms. If these notes are not set up properly the Medicaid applicant can be deemed to have gifted away assets – resulting in a penalty that would require paying the expensive nursing home bills for a period of time before Medicaid coverage would begin.

Many people recite a loan to an heir in their trust or will and attempt to deduct it from the child’s share. While this is one approach, the promissory note approach is a better foundation for imposing fairness. It can be enforced after death to continue payments to the estate which can then distribute the proceeds accordingly. Medicaid rules in fact prohibit cancellation of the note on death.

It is highly advisable to consult an elder law attorney when considering a loan to a family member to avoid these pitfalls.

Your Disabled Child’s Special Needs and Adulthood

Q.           My child with a disability is turning 18. Can he continue to get the publicly funded services we were able to get for him as a minor?


A.            Once your child turns 18 your legal authority over him ends. For example, you were able to get involved in his education through development of an Individual Education Plan (IEP) to assure that he received public benefits that enabled him to succeed at school. Now that he is an adult his financial and care needs are his legal responsibility.


Q.           My child can’t do this by herself. What can I do to help assure that she gets the services she needs?


A.            A first recommended step is to have your child apply for benefits under the Social Security Income (SSI) program at your local Social Security Office if your child has less than $2,000 of property in her own name. Once SSI is obtained she will be automatically eligible for Medicaid upon applying to the Michigan Department of Human Services. This will open the door to valuable community health services not otherwise available; particularly in regard to mental health.


Q.           My child is really not able to make informed decisions regarding his care and finances. How can I continue to step in and do that for him?


A.            There are a number of steps that can be taken to establish a continuing authority for you. In regard to Social Security, you should apply to the Social Security Administration to be a Representative Payee at the time SSI is applied for. This is the only agent for receipt of payments that Social Security will recognize.

Another step would be to establish a guardianship under the Michigan Mental Health Code. This approach does have the drawback of eliminating the rights of the disabled person to act independently, making them more vulnerable. It is a public record of developmental disability with a potential for stigmatization. Lastly, it is an expensive and time consuming court process. It should only be undertaken when necessary.

There are alternatives to guardianship which can eliminate these drawbacks and pave the way for an enhanced quality of life with the lowest degree of restrictions on an individual’s rights, such as Patient Advocate Designations for medical and mental healthcare and Durable Powers of Attorney for Finances. These legal documents serve much the same purpose as a guardianship and are strictly private, eliminating the potential for stigma and the added costs of a continuing court process.


Q.           Can I continue to provide financial support to my child while he or she is receiving government benefits?


A.            A special needs individual receiving an inheritance, lawsuit settlement, or monetary gift can be disqualified from having Social Security and Medicaid benefits if proper planning is not done.  A special needs trust can be utilized to protect their money and keep their savings below the Social Security and Medicaid requirement of $2,000. There are several forms of Special Needs Trusts and the design and administration of the trust is critical in order to provide all of the protection and benefits needed. A Special Needs Trust enables you to appoint someone you trust to manage assets and advocate for the individual. It also provides for an enhanced quality of life for the beneficiary and as well as allows one to be self-reliant and independent to the maximum extent possible.


Q.           I have seen standard forms on the internet and elsewhere. Can I use these forms?


A.            While these forms can be helpful for families that simply cannot afford an attorney, they are often not suitable for a given set of circumstances. Michigan law provides special requirements for these documents to be valid and protect your child’s government benefits. A standard form may not conform to those requirements. It is best to consult a special needs attorney for assistance in most cases.