In This Issue

"Anthony, thank you so much for all of your kind helpfulness and wise counsel! God Bless you for your help! You are so knowledgeable regarding Medicaid/VA issues."

"We want to express our thanks and appreciation for the excellent advice and service Lesley provided in preparing for our daughter's special needs trust.  This is a very difficult and complicated problem and we really value your expertise in dealing with it."

"Thank you so much for updating my Estate Planning documents. Due to your helpfulness, I feel much more at ease now that this matter has been so efficiently handled." 


Saturday, October 17th, 2015

Devereux's 4th Annual Family Resilience Conference:
On the Road to Resilience: Mapping Your Family's Journey

Philadelphia College of Osteopathic Medicine
8:30am - 4:00pm

The ELC Turns 40!

The Education Law Center is celebrating their 40th Anniversary!

September 16th - Crystal Tea Room - Philadelphia

For all news and events, visit


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by Anthony L. Marone, Esq.
McAndrews Law Offices, P.C.

Beginning on March 19, 2015, the Wolf Administration has slowly and deliberately terminated Healthy PA and made the new Affordable Care Act ("ACA") expansion program known as "Health Choices" available to Pennsylvania's residents.  Healthy PA was Pennsylvania's first attempt to extend health care coverage to the over one-half million uninsured Pennsylvania residents who do not qualify for medical insurance on the Health Care Exchange or through traditional Medical Assistance.  Healthy PA was designed to cover those uninsured, non-disabled Pennsylvania residents between the ages of 22 and 64 whose income is less than 138% of the federal poverty level ("FPL").
            Healthy PA, which began accepting applications in December, 2014, was beset with problems during its short existence.  Only about one-quarter of the eligible persons enrolled in the program.  Some persons who were receiving mental health and drug and alcohol treatment prior to enrollment in Healthy PA had their treatment restricted or terminated.  Many others found it difficult to navigate the new Private Coverage Options ("PCOs").  The PCOs were private insurers, paid by the Department of Human Services ("DHS"), who provided health care coverage to qualified persons.  Health care coverage through a PCO was similar to purchasing an individual plan on the Exchange.
            At this time, the Healthy PA program is essentially defunct.  On July 28, 2015 the Department of Human Services ("DHS") transitioned the remaining 79,272 persons from Healthy PA to Health Choices.  The final PCO transition also began on July 28, 2015.  On August 31, 2015 all PCOs were scheduled to be terminated and all health care coverage will be provided by Managed Care Organizations ("MCOs") through Health Choices.  MCOs are more commonly known as Health Maintenance Organizations ("HMOs") or Preferred Provider Networks ("PPOs") where a primary care doctor coordinates your care within a network of other providers.
            Health Choices is the full ACA expansion of the Medicaid program, known as Medical Assistance ("MA") in Pennsylvania.  Health Choices eliminated some of Healthy PA's limits on coverage.  For example, Health Choices removed the Healthy PA six-drug-per-month limit on prescription drug coverage.  Health Choices also removed the limits on psychiatric and drug and alcohol treatment, the inpatient psychiatric hospital limit of 30 days per year, and the inpatient rehabilitation limit of one admission per year.  Health Choices provides the same level of coverage for all enrolled, eligible adults.
            Health Choices created new categories of Medical Assistance eligibility while eliminating the categories related to Healthy PA.  The new categories include adults up to age 64, pregnant women, and certain women with breast or cervical cancer.  Although the transition for eligible persons is near completion, The DHS is still in the process of writing the regulations and policies that will govern Health Choices. 

Helpful links regarding Health Choices

by Lesley M. Mehalick, JD, LLM

Much confusion exists about the need for, and the purpose of, a Revocable Living Trust.  Many people are told that they need such a Trust to protect themselves and to avoid probate.   Revocable Living Trusts are complex documents that can be costly to prepare.  They are useful in a variety of very specific circumstances, but as discussed below, in Pennsylvania, Revocable Living Trusts are unnecessary in most cases. 
            A Revocable Living Trust is a Trust that a person, called the Grantor, creates, funds, and retains control over during his lifetime.  Generally, it acts as a Will substitute, meaning that it directs to whom property will go when the Grantor passes.  If funded and administered correctly, the Revocable Living Trust can have several benefits; namely, it can avoid the probate process.
            Probate is the procedure used when a person passes away and a "probate estate" is opened for the decedent.  A probate fee is imposed, and several court filings are necessitated.  In some states, probate can be a long and complicated process involving court hearings and expensive fees.  In Pennsylvania and many other states, the probate process is relatively straightforward and the fees involved are generally modest.  While the Revocable Living Trust can avoid opening a probate estate, it does not avoid many steps involved in administering an estate after a person passes.  For example, regardless of whether a person created a Revocable Living Trust or a Will, creditors must be paid, tax returns must be filed, and monies must be distributed to the beneficiaries.  As the Revocable Living Trust does not obviate these steps, its utility varies depending upon the probate process of the state where the decedent resided.   

  Click here to read the full article
by Elaine T. Yandrisevits, Esq.

Many people say that nothing is certain in life except death and taxes, and that is absolutely true in estate administration cases. There are several federal and state taxes (collectively referred to as "death taxes") that must be prepared and filed following an individual's death. 

In Pennsylvania, the most important death tax is the Pennsylvania Inheritance Tax, which is a tax on the transfer of assets from the decedent to his or her heirs. This tax is paid to the Pennsylvania Department of Revenue, and is a separate and distinct tax from any federal taxes that may be assessed. If the decedent is a Pennsylvania resident at the time of death, this tax is assessed on all tangible property and any real property located within Pennsylvania owned by the decedent. If the decedent is not a resident of Pennsylvania but owned real property in Pennsylvania at the time of his or her death, the Pennsylvania Inheritance Tax is only taxed on the real property located in Pennsylvania. 

Click here to read the full article
Guardianship is necessary if an adult individual lacks capacity to make and communicate his own decisions, did not sign a Power of Attorney during his lifetime, and needs a person to make medical decisions and assist with financial transactions on his behalf.  If an individual signed a Power of Attorney during his lifetime, then guardianship is typically not necessary, as the agent would be able to make medical and financial decisions during the principal's incapacity.  Some individuals, even if they are incapacitated and without a Power of Attorney, are able to function in the community without a guardian due to the availability of supportive family members and caregivers.  

When an interested party decides to file for guardianship, it could take several months to complete the guardianship process, as many county Orphans' Courts have high case loads.  There are, unfortunately, instances where an alleged incapacitated person is not able to wait several months to have a guardian appointed, and requires guardianship services on an emergency basis.  Pennsylvania law provides that when clear and convincing evidence demonstrates that the alleged incapacitated person appears to lack capacity, is in need of a guardian, and a failure to make such appointment will result in irreparable harm to the person or estate of the alleged incapacitated person, then an emergency guardianship is appropriate.  20 Pa. Code §5513.  Upon filing the petition for emergency guardianship with the Orphans' Court, a hearing is generally set to take place one to two days later.  Many of the procedural requirements necessary for a regular guardianship are dispensed with due to the emergency nature of the situation.  For instance, it is not necessary to give 20 days notice to the alleged incapacitated person and the members of his family; however, a citation must be served on alleged incapacitated person and a reasonable attempt to provide notice to his family members must be made.  Medical testimony must be provided at the hearing, along with the appearance and testimony of the proposed guardian. 


Here's what the Social Security Administration has to say: "Social Security has provided critical financial help to people of all ages for the last 80 years, and despite our age, we're far from retiring! As the Social Security program celebrates its historic birthday this August, we're reflecting on our diverse history, our current strengths, and ways we can continue to improve our services to you. On August 14, 1935, President Franklin D. Roosevelt signed the Social Security Act into law. In doing so, he promised the law would protect "the average citizen and his family against the loss of a job and against poverty-ridden old age." Today, we continue to provide financial security for our country's most vulnerable citizens. In fact, Social Security provides world-class service to millions of people every day - online, on the phone, and in our network of field offices across the country. As we celebrate 80 years, we're proud to present our "Celebrating the Past and Building the Future" http://www.socialsecurity.gov/80thanniversary/ anniversary website. There, you can read 80 interesting facts about an agency that touches everyone's life at some point or another! For example, did you know the original name of the Social Security Act was the Economic Security Act?"
Source/more: Social Security Administration - http://www.socialsecurity.gov/80thanniversary/

After nearly 30 years, the Obama administration wants to modernize the rules nursing homes must follow to qualify for Medicare and Medicaid payments. The hundreds of pages of proposed changes cover everything from meal times to use of antipsychotic drugs to staffing. Some are required by the Affordable Care Act and other recent federal laws, as well as the President's executive order directing agencies to simplify regulations and minimize the costs of compliance.
Officials unveiled the update as the White House Conference on Aging convened Monday. The once-a-decade conclave sets the agenda for meeting the diverse needs of older Americans, including long-term care options. This month also marks the 50th anniversary of the Medicare and Medicaid programs, which cover almost 125 million older, disabled or low-income Americans. Medicare and Medicaid beneficiaries make up the majority of residents in the country's more than 15,000 long-term care facilities. "The existing regulations don't even conceive of electronic communications the way they exist today," said Dr. Shari Ling, Medicare's deputy chief medical officer. "Also there have been significant advances in the science and delivery of health care that just weren't imagined at the time the rules were originally written.

Wyomissing, PA
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