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Federal regulators recently issue a warning health care providers accepting federal funding to be on the lookout for inappropriate prescriptions of a powerful antipsychotic drug commonly used in nursing homes to treat a host of disruptive behaviors. The memo comes from the Centers for Medicare and Medicaid Studies and applies to providers accepting Medicare Part D,  including nursing homes and pharmaceutical distributors.

The drug in question is called Nuedexta and is commonly used to treat a rare condition marked by uncontrollable laughing and crying, called pseudobulbar affect (PBA) but is suspected to also be overprescribed for so-called “off label” uses. In the past year, several media reports have indicated that doctors at nursing homes have been overprescribing Nuedexta in order to control not only the symptoms of those struggling with dementia but also generally unruly behavior in residents without dementia.

While Neudexta’s maker, Avanir Pharmaceuticals, claims many dementia patients suffer from PBA and benefit from the drug, the company has also generated millions of dollars in annual sales in nursing homes since the drug launched in 2011. In most cases, the federal government picked up the costs for those bills when it reimbursed nursing homes through Medicare’s Part D program.

A recent survey of family home caregivers revealed that many of these individuals are strained and stressed out by their duties the demands of their loved ones with developmental disabilities and deeply concerned about the future. The survey analyzed the feelings of over 3,000 individuals caring for family members at home with developmental disabilities and found that 95 percent said they were stressed out with nearly half describing themselves as very or extremely stressed.

The questionnaire was conducted by Family & Individual Needs for Disability Supports (FINDS) Community Report and released by The Arc and The University of Minnesota’s Institute on Community Integration. The data collected is based on responses from 3,398 unpaid caregivers across the country who responded to an online survey conducted between January and April 2017.

Researchers conducted the FINDS primarily through an on-line survey administered between January to April of 2017 and made available in English and Spanish paper versions. Those invited to take part in the survey included caregivers who were family members or friends providing support to people with intellectual or developmental disabilities.

A recent analysis by researchers at the University of Wisconsin-Madison revealed that employers contributed significantly higher amounts of capital to defined-benefit pension plans in 2017, likely because of the new tax law signed by President Donald Trump. That law cut tax corporate tax rates from 35 to 21 percent starting this year and provided an incentive for corporations to increase deductions in 2017, including deductions for pension contributions.

The study analyzed data samples taken from over 400 non-financial firm which calculate their financial statements on a calendar-year basis and found that, on average, that firms increased their unexpected pension contributions by $16 million each. These unexpected pension contributions are considered the difference between the amount a firm contributed and the amount of money it was expected to contribute on prior-year financial statements.

Those numbers came out to a 24-percent increase in 2017 on average compared to the same averages for individual firms from 2014 to 2016. Furthermore, the study determined that taxpaying firms made larger unexpected contributions than non-taxpaying firms which the researchers took as a sign that the increased contributions could be due to the cut in corporate tax rates.

A recent poll conducted by the University of Michigan showed that older Americans are slow to embrace the use of their health care provider’s secure online patient access portals to communicate with the doctors and other health care providers. Despite the widespread availability of online healthcare access portals, only about half of people between the ages of 50 to 80-years old have set up an account on a secure online access sites offered by their health care provider, according to the new findings from the National Poll on Healthy Aging conducted by the University of Michigan.

However, those with higher educations and income levels had higher rates of patient portal use even though those with lower household incomes and less education generally have more healthcare needs. Additionally, age appears to play a role in adoption rates of the technology as those aged 65-years and older were more likely than people in their 50s and early 60s to report they do not like using computers to communicate about their health or are generally comfortable with technology.

The poll, sponsored by AARP and University of Michigan’s academic medical center, Michigan Medicine, analyzed the preferences of over 2,000 participants and found that among older adults who had not yet set up access to a patient portal, 52-percent cited concerns about communicating online about health information. Another 50-percent reported they did not see the need for this kind of access to their health information and about 40-percent simply had not gotten around to setting up their access yet.

A pair of proposed bills are working their way through the halls of Congress that could help encourage Americans to make voluntary contributions to their retirement funds, helping them live more comfortable and financially stable lives in their golden years. With looming changes to Social Security and rising healthcare costs, Americans young and old need to take heed of warnings by economists and activity plan for their retirements.

One of those bills is the Retirement Enhancement and Savings Act of 2018, jointly sponsored by Orrin Hatch (R-Utah) and Ron Wyden (D-Oregon), which is a collection of smaller bills that combined call help ordinary people make larger contributions to their retirement accounts. This legislation mirrors a similar proposal approved by the Finance Committee in 2016 but floundered when Congress adjourned before taking any action on the bill.The bill would help participants in retirement savings programs think in terms of lifetime income instead of accumulated balances.

The Retirement Enhancement and Savings Act of 2018 would require benefit statements include estimates of lifetime income at least once a year and would direct the Department of Labor to develop a model for constructing income estimates. The Act would also provide fiduciaries a safer place for selecting a lifetime income provider thus eliminating uncertainty concerning applicable fiduciary standards for offering lifetime income benefits under a defined-contribution plan.

With all of the discussion surrounding repealing the estate tax and other significant tax reforms, it can be difficult to understand exactly how these proposed changes might affect your estate. For most people in the United States, the estate tax is not a concern. That is because you need an individual estate worth $5.49 million or more before the tax will even apply. However, there are still a number of other concerns to keep in mind in order to make the most informed decisions about your estate plan because there are a number of other factors that could impact the overall value of your estate. A recent article from Financial-Planning.com helps put some of these risks into perspective.

Intestacy

One of the biggest risks to assets in an estate is dying without an estate plan in place to protect them. While your estate may not be subject to the federal estate tax, it could be subject to significant state-level taxes and those penalties can take a large chunk of your assets if you do not have an estate plan in place. Intestate succession will also determine the percentage of your assets that will be distributed to the heirs covered by your state’s intestate succession statute. This may not be in line with how you want your assets to be distributed, so making sure that you have a valid and up-to-date estate plan is the first step in avoiding any hidden financial risks that could impact your assets.

It is a common misconception that estate planning is only a concern for those individuals with sizeable estates. This is simply not true. Everyone can benefit from comprehensive estate planning, even individuals with average or small estates. A recent article from CNBC reminds us of the importance of having a Will regardless of our overall financial situation, age, or other factors that may lead us to believe a Will is not necessary.

Engaging in Estate Planning

As the article points out, even a checking account and a car present a reason for having a Will regardless of any other assets that might exist. The law requires that title to that vehicle must be changed to whomever the new owner is and there must be someone to distribute the assets in your checking account. Absent a Will, you risk losing a great deal of assets to the state either by default because of failure to nominate an heir or because of the legal costs involved in the probate process where those assets will end up.

Regardless of the size of your estate, comprehensive estate planning can help you make the most of the assets you have worked hard to build. It is important to make sure that you take a thorough approach to estate planning in order to preserve as many assets as possible, and also to make sure that you make dealing with a loss as easy on your family members and friends as possible. One of the most common ways to do that is to include funeral arrangement and instructions for the disposition of your remains. There are a number of approaches to doing this, and ultimately the terms you set forth will be unique to you and your family’s wants and needs. However, a recent article from the National Law Review provides some helpful information about this aspect of estate planning.

Pre-Death Arrangements

Most states allow you to iron out many of the details of your funeral arrangements and the disposition of your remains ahead of time. In many cases, these are integral pieces of a comprehensive estate plan. You can dictate whether you wish to be buried or cremated; specify the location of your burial; specify any memorialization; and even designate one individual to make sure your funeral arrangements and the disposition of your remains are conducted in the way you have chosen. Depending on the state you live in, nominating an individual to carry out your particular wishes gives them priority over other individuals that would otherwise potentially have the right to make these decisions for you. This can be helpful because, no matter how carefully you plan, it is impossible to predict all of the circumstances that could arise and you will want someone that you trust in the position to determine the best course of action. More and more, these types of arrangements are becoming commonplace alongside powers of attorney and healthcare directives. In many ways, completing this type of directive can be just as important – and it will likely help your family avoid additional stress and grief during a difficult time.

Debt is an all-too-common part of our everyday life. In fact, Marketwatch.com lists American personal debt – including homes, student loans, and auto loans – at approximately two billion dollars. This figure does not include credit card debt. However, as daunting as debt may seem, making sure to consider your debt when determining how best to engage in comprehensive estate planning is an important part of your debt management strategy.

Understanding Your Debt

One of the first things to consider when approaching debt and estate planning is whether your debt will become someone else’s responsibility when you die. An article from NerdWallet.com helps shed some light on what happens to various types of debt after the individual responsible for that debt passes away. Some common examples of debt and what may happen to that debt include: