Among all the changes you must make when you move to a new state—driver's license, voter registration—don't forget your will. While your will should still be valid in the new state, there may be differences in the new state's laws that may make certain provisions of the will invalid. In addition, moving is a good excuse to consult an attorney to make sure your estate plan in general is up to date.

Property laws can vary from state to state. It is especially important to have your estate plan reviewed if you move from a common law state to a community property state like California. In a common law state each spouse's property is owned individually, while in a community property state, property acquired during the marriage is considered community property. In addition, states may have different rules about when co-owned property may pass to the surviving owner and when it may pass under the will.

Other things to consider are whether there is any language you can add to the will to make it easier to probate in the new state and whether your executor still makes sense based on your new location. Other pieces of your estate plan may need updating as well. For example, the state may have different rules for powers of attorney or health care directives.

One of the major benefits of Medicare is its coverage of hospitalization. Medicare covers 90 days of hospitalization per illness (plus a 60-day "lifetime reserve"). However, if you are admitted to a hospital as a Medicare patient, the hospital may try to discharge you before you are ready. While the hospital can't force you to leave, it can begin charging you for services. Therefore, it is important to know your rights and how to appeal. Even if you don't win your appeal, appealing can buy you crucial extra days of Medicare coverage.

Starting July 1, 2007, new notice requirements for Medicare patients being discharged from the hospital go into effect. The notices give Medicare patients information about their discharge and appeal rights. Previously hospitals were required to give patients a written notice before discharge called "Hospital-Issued Notice of Non-Coverage" (HINN). Hospitals may still give HINNs in certain circumstances, but the new rules require hospitals to give two notices to patients of their rights—one right after admission and one before discharge.

Within two days of admission to a hospital, the hospital must give you a notice called "An Important Message from Medicare about Your Rights" (IM) explaining your discharge and appeal rights. You must read the notice, sign it, and date it. Two days before discharge, the hospital must give you another copy of the IM. If you are in the hospital for three days or less, the hospital only needs to give you one notice.

Once you receive a discharge decision and you are not ready to leave, you should immediately contact your local Medicare Quality Improvement Organization (QIO). A QIO is a group of doctors and other professionals who monitor the quality of care delivered to Medicare beneficiaries. They are paid by the federal government and not affiliated with a hospital or HMO. The QIO in California is Lumetra. The phone number should be on the IM. You can also click here for a list of QIO’s in other states.

It is very important to contact the QIO right away. You must contact the QIO by noon on the first business day after you receive the discharge notice. If you do this, you will not have to pay for your care while you wait for your discharge to be reviewed. If you don't contact the QIO by noon, the hospital can begin charging you on the third day after you receive the discharge notice.

Once you request a QIO review, the hospital is required to give you a "Detailed Notice of Discharge." You should receive the notice no later than noon the day after you request a QIO review. The detailed notice explains the medical reason behind the discharge.

The QIO will conduct a review of the discharge. The QIO doctors will review the medical necessity, appropriateness, and the quality of hospital treatment furnished to you. The hospital cannot discharge you while the QIO is reviewing the discharge decision, and you will not have to pay for the additional days in the hospital. If you don't agree with the QIO's decision, you can ask it to reconsider. It must issue a decision within three days.

If, after the reconsideration, the QIO still agrees with the hospital's decision, you can appeal to an administrative law judge (ALJ). You will probably need legal counsel to help you through this process. You can appeal the ALJ's decision to the Department of Health and Human Services, Departmental Appeals Board (DAB). Finally, if you don't agree with the DAB decision, you can appeal to federal court as long as at least $1,000 is at stake.

If you have additional questions, please visit the Lumetra website, or contact the San Diego Elder Law Center.

A group of disabled individuals has filed a class action lawsuit against the state of Illinois under the Americans with Disabilities Act (ADA), asking the state to permit them to receive long-term care services at home rather than in a nursing home. The lawsuit alleges the state has been violating the ADA by not providing enough resources to allow the individuals to receive care in their homes or communities.

Represented by three public interest agencies -- Access Living, Equip for Equality, and the American Civil Liberties Union of Illinois -- as well as Stephen F. Gold, a national disability rights lawyer, the disabled individuals allege that they are being segregated in nursing homes and that unnecessary institutionalization is discrimination under the ADA. According to the lawsuit, 60 percent of disabled, non-elderly nursing home residents would rather receive care at home.

The individuals are asking the court to order Illinois officials to assess nursing home residents for community long-term care services, inform residents of home and community based options, and provide eligible residents with services and support in the community instead of requiring them to move into a nursing home. “Under federal law, nursing home residents have the right to receive long-term programs in the most integrated setting appropriate to their needs,” said Ed Mullen of Ross, Dixon & Bell, LLP. “The plaintiffs who filed the complaint today, as well as many others, have had that right systemically denied.”

"It's really an issue of money," Mullen told the Chicago Tribune. "[The state is] making the choice to put more money into institutions than community care." According to the Tribune, the state claims it is committed to making sure individuals with disabilities can remain in their homes.

California, says San Diego Elder Law Center attorney Philip P. Lindsley, has a progressive Medi-Cal waiver program experimenting with home placements under the Medi-Cal Long Term Care program.”  “Unfortunately,” says Lindsley,  the number of spaces available in the program is small and the waiting list is long.  With good data from this pilot project, we may see the availability of Long Term Care Medi-Cal in a home care setting expand.”

To read the Chicago Tribune article about the lawsuit, click here.

To read the complaint, click here.