Gadgetwise Blog: Q.& A.: Fixing Incorrect Photo Dates

Why do my pictures have the wrong dates on them when I transfer them from the camera to the computer with the Picasa program?

One reason may be that the date and time settings on the camera were incorrect when the photos were taken. When you snap the shutter, a digital camera records more than just the image; it also embeds other data into the photo file.

This information includes the date, time, image dimensions and name of the camera manufacturer. If the camera’s own date setting is incorrect, it will write the wrong time in the photo file. (Google has more information about viewing a photo’s embedded data in Picasa on its site.)

To fix the problem for future photos you take, go into your camera’s settings menu and correct the date and time. For the photos you have already imported into Picasa 3.5 and later, select the pictures with the incorrect dates in a folder or album, go to the Tools menu and choose “Adjust Date and Time.” Enter the correct information in the New Photo Date area and click O.K.

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The New Old Age Blog: In Blended Families, Responsibility Blurs

Every year, Fran McDowell waited for the summer week when she would sing in a choral festival in the North Carolina mountains, then spend a few days in a lakeside cabin with close women friends.

That getaway grew more complicated to arrange — but perhaps more necessary — after her husband, Herb Beadle, was diagnosed with Alzheimer’s disease. They had a “gloriously happy” marriage — her first, his second — for 11 years, and she was more than willing to care for him in sickness as in health. But he could no longer manage alone in their Atlanta home.

For a few years, other family members pitched in to allow Ms. McDowell her cherished vacation. Eventually, though, she had to ask her husband’s daughter, a medical professional in another state, to take him into her home for a week.

She said no, then yes. Then, the day before Ms. McDowell was to drive him there, her stepdaughter again refused, leaving no time for alternate arrangements. If this had been her biological child, “I would have said, ‘Come on, don’t do this to me,’” Ms. McDowell said. Instead, reluctant to make waves, she canceled her trip.

“I think confrontation is riskier for stepparents,” she told me. “I was the compliant one who would bite my tongue rather than say what I thought.”

Ms. McDowell never told her stepdaughter, or anyone in the family, how angry and disappointed she was, or how difficult it was becoming to care for their father, who died three years ago at 86. She told the members of her dementia caregivers support group instead.

It was that group’s leader, Moira Keller, who e-mailed me to suggest this topic. A clinical social worker with the Sixty Plus program at Piedmont Atlanta Hospital, she wrote that “one of the biggest challenges I have is blended families in later life.”

Though I’ve written about the way the 1970s’ spike in divorces could complicate caregiving for adult children — more households to sustain, more siblings to either help or hinder — I hadn’t considered the impact on the older people themselves.

But Ms. Keller seems to be onto something. “The generation most likely to have stepchildren” — the boomers — “don’t need much care yet,” said Merril Silverstein, a Syracuse University sociologist co-editing a coming issue of the Journal of Marriage and the Family on stepfamilies in later life. “The crunch will come in 10 or 20 years.”

Initially, many adult children whose divorced or widowed parents remarry seem delighted, Ms. Keller said when we spoke. “They’re thrilled that Mom or Dad isn’t alone,” she said. “It’s a wonderful thing — until somebody gets sick.”

Then, she has found, “it gets really blurry. Who’s going to do what?” Grown children don’t have much history with these new spouses; they often feel less responsibility to intervene or help out, and stepparents may be unwilling to ask. Perhaps it’s unclear whether children or new spouses have decision-making authority.

“Older couples in this situation fall through the cracks,” Ms. Keller said.

Research shows that the ties which lead adult children to become caregivers — depending on how much contact they have with parents, how nearby they live, how obligated they feel — are weaker in stepchildren, Dr. Silverstein said. Money sometimes enters the equation too, Ms. Keller added, if biological children resent a parent’s spending their presumed inheritance on care for an ailing stepparent.

Adela Betsill, another of Ms. Keller’s support group members, married her longtime partner five years ago — her second marriage, his third. She has since given up her interior design business to care for Robert who, at 72, has also developed Alzheimer’s disease. His two children have had little involvement — perhaps because she’s just 49 and presumed able to handle everything.

Thus, though Robert’s son works from an office in their home, if Ms. Betsill needed to go out and asked him to remind his father to eat lunch, “he might, or he might not,” she said. “I don’t think he realizes it’s a burden.” So she has not asked.

Would it be different if she were his biological mother and he saw her wearing out under the strain? She thinks so, but it’s hard to know. After all, biological families also experience plenty of conflict and avoidance as elders age.

Still, that sense of reciprocity we often hear from caregivers — she took care of me when I was young, so I need to help out now that she’s old — doesn’t apply in late-life stepfamilies. Ms. Betsill didn’t raise this man, or his half sister.

Older couples who marry or remarry often discuss their finances, Ms. Keller has found. (An elder attorney, Craig Reaves, discussed the legal consequences here.) But illness and dependence may prove even more difficult subjects to broach.

“If I could yell one thing from a mountaintop,” Ms. Keller said, “it’s to talk about this stuff, too. Who’s going to take care of you if you become sick? Talk about that while you’re still healthy.”


Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

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The New Old Age Blog: In Blended Families, Responsibility Blurs

Every year, Fran McDowell waited for the summer week when she would sing in a choral festival in the North Carolina mountains, then spend a few days in a lakeside cabin with close women friends.

That getaway grew more complicated to arrange — but perhaps more necessary — after her husband, Herb Beadle, was diagnosed with Alzheimer’s disease. They had a “gloriously happy” marriage — her first, his second — for 11 years, and she was more than willing to care for him in sickness as in health. But he could no longer manage alone in their Atlanta home.

For a few years, other family members pitched in to allow Ms. McDowell her cherished vacation. Eventually, though, she had to ask her husband’s daughter, a medical professional in another state, to take him into her home for a week.

She said no, then yes. Then, the day before Ms. McDowell was to drive him there, her stepdaughter again refused, leaving no time for alternate arrangements. If this had been her biological child, “I would have said, ‘Come on, don’t do this to me,’” Ms. McDowell said. Instead, reluctant to make waves, she canceled her trip.

“I think confrontation is riskier for stepparents,” she told me. “I was the compliant one who would bite my tongue rather than say what I thought.”

Ms. McDowell never told her stepdaughter, or anyone in the family, how angry and disappointed she was, or how difficult it was becoming to care for their father, who died three years ago at 86. She told the members of her dementia caregivers support group instead.

It was that group’s leader, Moira Keller, who e-mailed me to suggest this topic. A clinical social worker with the Sixty Plus program at Piedmont Atlanta Hospital, she wrote that “one of the biggest challenges I have is blended families in later life.”

Though I’ve written about the way the 1970s’ spike in divorces could complicate caregiving for adult children — more households to sustain, more siblings to either help or hinder — I hadn’t considered the impact on the older people themselves.

But Ms. Keller seems to be onto something. “The generation most likely to have stepchildren” — the boomers — “don’t need much care yet,” said Merril Silverstein, a Syracuse University sociologist co-editing a coming issue of the Journal of Marriage and the Family on stepfamilies in later life. “The crunch will come in 10 or 20 years.”

Initially, many adult children whose divorced or widowed parents remarry seem delighted, Ms. Keller said when we spoke. “They’re thrilled that Mom or Dad isn’t alone,” she said. “It’s a wonderful thing — until somebody gets sick.”

Then, she has found, “it gets really blurry. Who’s going to do what?” Grown children don’t have much history with these new spouses; they often feel less responsibility to intervene or help out, and stepparents may be unwilling to ask. Perhaps it’s unclear whether children or new spouses have decision-making authority.

“Older couples in this situation fall through the cracks,” Ms. Keller said.

Research shows that the ties which lead adult children to become caregivers — depending on how much contact they have with parents, how nearby they live, how obligated they feel — are weaker in stepchildren, Dr. Silverstein said. Money sometimes enters the equation too, Ms. Keller added, if biological children resent a parent’s spending their presumed inheritance on care for an ailing stepparent.

Adela Betsill, another of Ms. Keller’s support group members, married her longtime partner five years ago — her second marriage, his third. She has since given up her interior design business to care for Robert who, at 72, has also developed Alzheimer’s disease. His two children have had little involvement — perhaps because she’s just 49 and presumed able to handle everything.

Thus, though Robert’s son works from an office in their home, if Ms. Betsill needed to go out and asked him to remind his father to eat lunch, “he might, or he might not,” she said. “I don’t think he realizes it’s a burden.” So she has not asked.

Would it be different if she were his biological mother and he saw her wearing out under the strain? She thinks so, but it’s hard to know. After all, biological families also experience plenty of conflict and avoidance as elders age.

Still, that sense of reciprocity we often hear from caregivers — she took care of me when I was young, so I need to help out now that she’s old — doesn’t apply in late-life stepfamilies. Ms. Betsill didn’t raise this man, or his half sister.

Older couples who marry or remarry often discuss their finances, Ms. Keller has found. (An elder attorney, Craig Reaves, discussed the legal consequences here.) But illness and dependence may prove even more difficult subjects to broach.

“If I could yell one thing from a mountaintop,” Ms. Keller said, “it’s to talk about this stuff, too. Who’s going to take care of you if you become sick? Talk about that while you’re still healthy.”


Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

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DealBook: Liberty Global in Talks to Buy Virgin Media

6:59 a.m. | Updated

LONDON – Liberty Global, the international cable company owned by the American billionaire John C. Malone, is in discussions to buy the British cable company Virgin Media.

In a brief statement on Tuesday, Virgin Media said it was in talks with Liberty Global, which serves almost 20 million customers worldwide.

“Any such transaction would be subject to regulatory and other conditions,” Virgin Media said in a statement. Spokesmen for both Virgin Media and Liberty Global declined to comment further.

Shares in Virgin Media, which was formed through several mergers of small British cable companies and a cellphone company in the 2000s, rose almost 16 percent in afternoon trading in London on Tuesday.

Its shares have jumped almost 60 percent in the last 12 months, as more consumers sign up for so-called bundled services, including Internet and cellphone contracts.

The company, whose primary listing is on Nasdaq, is the second-largest pay-TV provider in Britain after BSkyB, which is partly owned by Rupert Murdoch‘s News Corporation.

Virgin Media’s market capitalization stands at $10.4 billion. Including debt, Virgin Media’s enterprise value is around $19.4 billion, according to data from Thomson Reuters.

To secure a deal, analysts at Espirito Santo said Liberty Global may have to pay as much as $24 billion, though they questioned whether the international cable company could afford to fund the acquisition because of its existing high levels of debt.

Analysts also said that it would be difficult for Liberty Global to make costs savings between its current European operations and those of Virgin Media, adding that Liberty had waited to make its move for Virgin Media until the British cable operator had carried out a series of upgrades to its network and restructured its debt.

“Unless another bidder comes out of the woodwork, it’s hard to see much more of a premium on the price,” said Patrick Yau, a media analyst at Peel Hunt in London.

The British billionaire Richard Branson, whose Virgin brand is now used for a variety of products and services, including airlines and banks, owns less than 3 percent of Virgin Media.

While the British cable operator has been picking up market share, the company currently has 4.9 million customers, or roughly half the number of subscribers as its larger rival, BSkyB, according to filings from the companies.

A potential deal for Virgin Media would put Mr. Malone head-to-head with Mr. Murdoch, his longtime rival.

In 2008, the Liberty Group, which has operations in 13 countries, completed its purchase of a controlling stake in DirecTV, the satellite television provider, from News Corporation in a cash-and-equity deal worth roughly $11 billion.

The deal came after Mr. Malone’s purchase of a 16 percent stake in News Corporation, which he then traded for the satellite television operator, a number of regional sports networks and around $550 million cash.

Liberty Global has been expanding its presence in Europe and has operations from Ireland to Romania, though it failed last month in its bid to acquire the Belgian telecommunications company Telenet Group for $2.7 billion. Liberty Global currently owns a 58 percent stake in Telenet.

In August, Liberty Media, the media conglomerate also controlled by Mr. Malone, agreed to buy a stake in Barnes & Noble for $204 million, but declined to buy the bookseller outright.

The move disappointed some investors after Liberty had earlier offered to buy a 70 percent stake of Barnes & Noble for $17 a share if its chairman, Leonard S. Riggio, who owns around 30 percent of the company, agreed to the deal.

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The Lede Blog: Frank Video of Mass Sexual Assault in Cairo Is Released by Anti-Harassment Activists

Egyptian activists released a brutally frank video on Friday, using images recorded during the mass sexual assault of a woman last week in Cairo’s Tahrir Square to urge volunteers to join their campaign against attacks during demonstrations.

The video, created by the filmmakers Aida Elkashef and Salam Yousry, uses disturbing overhead images of a crowd of men swarming around a woman being assaulted just out of view to explain the work of Op Anti-SH, one of two new initiatives to combat the sexual harassment and rape of female protesters.

A video produced by Egyptian activists uses images recorded during the mass sexual assault of a woman in Cairo’s Tahrir Square last week, on the second anniversary of the Egyptian revolution.

While the video includes no graphic images and shows that volunteers did eventually manage to help the woman to a safe location — near the KFC in the square — the detailed description of the woman’s assault stunned some viewers.

After Egyptians expressed shock at another video clip — the images of police officers stripping and beating a male protester in Cairo that were broadcast live on Friday night — one activist, Sarah Naguib, argued that such brutality is depressingly routine two years after the Egyptian revolution began.

Despite that reality, the Op Anti-SH activists vow to continue their struggle.

In a video interview on the initiative published on Saturday, one of the women involved in Op Anti-SH, Engy Ghozlan, said: “This is our country, and we will not be silent about sexual harassment, not the type that happens to us every day, nor that of Tahrir. It will end, it cannot continue, because we believe Egypt deserves better.”

“In Egypt,” she added, “there is no revolution without the participation of women or without their security.”

A video report by a journalist, Simon Hanna, on Op Anti-SH for the news site Ahram Online.


This post has been revised to reflect the following correction:

Correction: February 4, 2013

An earlier version of this post incorrectly described a comment from the activist Sarah Naguib as a response to the video of sexual assault in Tahrir, rather than to video of police stripping and beating a male protester on Friday.

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Gadgetwise Blog: Q.& A.: Recording Video on an SD Card

How many minutes of video can I fit on the 16-gigabyte Secure Digital memory card in my camera?

The amount of video you can fit on your camera’s memory card can depend on the camera, the image quality and any special-effects modes you may be using while filming. The video section of your camera’s manual should have some specific answers on recording times for the different settings. If you chucked your manual right after you got the camera or cannot find it, check the support area of your manufacturer’s Web site or try an online manual repository like Retrevo.

For example, on the PowerShot S95 camera, Canon’s manual says you should be able to fit approximately one hour, 42 minutes and 57 seconds of video on a 16-gigabyte card when recording video at the high-definition setting of 1,280 by 720 pixels (at 24 frames per second). Switching to the standard-quality setting of 640 by 480 pixels (at 30 frames per second) lets you fit two hours, 59 minutes and three seconds of video on a 16-gigabyte SD card.

If you drop the quality level even lower to the 320 by 240 pixels (at 30 frames per second) setting, you can store more than eight hours of video on the card. Video clips may have a maximum size of four gigabytes or around 30 minutes in length at the high-definition setting, but you can resume recording new clips until the card is full.

While your camera’s manual should have more precise information, the SD Association, (an industry group devoted to creating technical standards for the Secure Digital format), has some basic information on how many minutes of video can fit on SD cards of different capacities on its site. The page also provides estimates on how many photos or approximate minutes of music fit on various SD cards.

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The New Old Age Blog: Therapy Plateau No Longer Ends Coverage

Ellen Gorman, 72, a New York psychotherapist, can’t walk very far and gets around the city mainly by taxi, “which is really expensive,” she said. Twice since 2008 her physical therapy was discontinued because she wasn’t progressing. But after a knee replacement last year, she is getting physical therapy again, exercising with her therapist and building up her endurance by walking in the hallway of her Manhattan apartment building.

“Before this, I was getting weaker and weaker, and I just kept caving in,” she said.

Because of an action by Congress and a recent court settlement, Medicare probably won’t cut off Ms. Gorman’s physical therapy again should her progress level off — as long as her doctor says it is medically necessary.

Congress continued for another year a little-known process that allows exceptions to what Medicare pays for physical, occupational and speech therapy. The Medicare limits before the exceptions are $1,900 for physical and speech therapy this year, and $1,900 for occupational therapy.

In addition, the settlement of a class-action lawsuit last month now means that Medicare is prohibited from denying patients coverage for skilled nursing care, home health services or outpatient therapy because they had reached a “plateau,” and their conditions were not improving. That will allow people with Medicare who have chronic health problems and disabilities to get the therapy and other skilled care that they need for as long as they need it, if they meet other coverage criteria.

The settlement is expected to affect thousands, and possibly millions, of Medicare beneficiaries with chronic health problems like Parkinson’s or Alzheimer’s disease, stroke, multiple sclerosis and spinal cord injuries. It could also help families, as well as the overburdened Medicare budget, delay costly nursing home care by enabling seniors to live longer in their own homes.

“Under this settlement, Medicare policy will be clarified to ensure that claims from providers are reimbursed consistently and appropriately and not denied solely based on a rule-of-thumb determination that a beneficiary’s condition is not improving,” said Fabien Levy, a spokesman for the U. S. Department of Health and Human Services, which includes the Medicare program.

The lawsuit was filed by the Center for Medicare Advocacy and Vermont Legal Aid on behalf of four Medicare patients and five national organizations, including the National Multiple Sclerosis Society, Parkinson’s Action Network and the Alzheimer’s Association. A tentative settlement had been reached in October and on Jan. 24 a federal judge in Vermont approved the deal.

For seniors getting skilled services at home under a doctor’s order, the settlement means Medicare’s home health coverage has no time limit, Margaret Murphy told lawyers attending the annual meeting of the National Academy of Elder Law Attorneys in Washington, D. C., shortly after the then-tentative settlement was announced.

The coverage “can go on for years and years, if your doctor orders it,” said Ms. Murphy, the center’s associate director, who added that patients must be homebound (though not bedbound) and need intermittent care — every couple of days or weeks – that can only be provided by a physical therapist, nurse or other trained health care professional. When physical therapy is provided as part of Medicare’s home health benefit, the therapy dollar limits may not apply.

The settlement ensures that nursing home residents will also get coverage for skilled care regardless of improvement, but does not change the duration, which is still limited to up to 100 days per “benefit period.” That begins when a patient is admitted as an inpatient to a hospital or a nursing home for skilled care and ends after 60 days without skilled care. The agreement preserves the requirement that they must also have spent at least three days as inpatients in a hospital.

Federal officials say the settlement is not a change in Medicare coverage rules, but that statement may surprise many beneficiaries and providers.

“If someone isn’t making progress, I say, ‘Listen, I’m sorry but Medicare’s not going to cover this so you can come in for a few more sessions but then I have to let you go,’ ” said Greg Babiec, a physical therapist and one of the owners of Evolve, a private therapy practice with offices in Manhattan and Brooklyn. He had not heard about the settlement.

Beneficiaries also often lose Medicare coverage for outpatient therapy because they hit the payment limit. But under the exceptions process Congress continued for another year, the health care provider can put an additional code on the claim that indicates further treatment above the $1,900 limit is medically necessary. When treatment costs reach $3,700, the provider can submit medical documentation to support a request for another exception to cover 20 more sessions. (A Medicare fact sheet provides some additional details, but has not been updated for 2013.)

In 2011, nearly five million seniors received therapy services at a cost of $5.7 billion, and about one out of every four received an exception to the then-$1,870 limit, according to the Medicare Payment Advisory Commission, an independent government agency that advises Congress.

Just a few hours before the settlement was approved, Rachel DeGolia learned that her 87-year-old father in Chicago was going to have to stop therapy because he stopped showing improvement — again.

“Every time he stops going to physical therapy, he starts to backslide in terms of his balance, his strength and his mobility,” said Ms. DeGolia, executive director of the Universal Health Care Action Network, a national advocacy group in Cleveland. His physical therapist did not know Medicare will cover therapy to prevent her father’s condition from getting worse.

Under the settlement, Medicare officials have until next January to straighten things out by notifying health care providers. Beneficiaries are not among those to be contacted, and so far the federal officials have not issued a formal statement on the settlement.

But patients don’t have to wait for their provider to get the official word, said Judith Stein, the lead attorney for the plaintiffs and executive director of the Center for Medicare Advocacy. “This isn’t a clandestine settlement,” she said.

The center’s Web site offers free “self-help” packets explaining how to challenge a denial of coverage that is based on the lack of improvement. Ms. Stein also advises beneficiaries to show a copy of the settlement — also available from the Web site — to your health care provider at your next physical therapy appointment if you are concerned about losing Medicare coverage. (If you follow this advice, let us know what happens.)

The Web site also explains how beneficiaries can request a review of their case if they received skilled nursing or therapy services in a skilled nursing facility, at home or as outpatients and were denied Medicare coverage because of a lack of progress after Jan. 18, 2011, when the lawsuit was filed.

Dean Lerner relied on the settlement last month to ensure that his brother-in-law would continue to receive Medicare physical therapy coverage.

“My brother-in-law in St. Louis suffers from Parkinson’s disease, and has for many years, and my sister is having a devil of a time helping him as his disease progresses,” said Mr. Lerner, a retired lawyer and state health official in Des Moines, who is also a Medicaid consultant.

A physical therapist teaches his brother-in-law to stand, turn and use a walker and maintain what little strength he still has. But because his condition hasn’t improved, the therapist said Medicare would not pay for additional sessions.

“But for my being an attorney, the outcome may well have been very different, and that shouldn’t be,” he said. “Why should you have to fight?”

Read More..

The New Old Age Blog: Therapy Plateau No Longer Ends Coverage

Ellen Gorman, 72, a New York psychotherapist, can’t walk very far and gets around the city mainly by taxi, “which is really expensive,” she said. Twice since 2008 her physical therapy was discontinued because she wasn’t progressing. But after a knee replacement last year, she is getting physical therapy again, exercising with her therapist and building up her endurance by walking in the hallway of her Manhattan apartment building.

“Before this, I was getting weaker and weaker, and I just kept caving in,” she said.

Because of an action by Congress and a recent court settlement, Medicare probably won’t cut off Ms. Gorman’s physical therapy again should her progress level off — as long as her doctor says it is medically necessary.

Congress continued for another year a little-known process that allows exceptions to what Medicare pays for physical, occupational and speech therapy. The Medicare limits before the exceptions are $1,900 for physical and speech therapy this year, and $1,900 for occupational therapy.

In addition, the settlement of a class-action lawsuit last month now means that Medicare is prohibited from denying patients coverage for skilled nursing care, home health services or outpatient therapy because they had reached a “plateau,” and their conditions were not improving. That will allow people with Medicare who have chronic health problems and disabilities to get the therapy and other skilled care that they need for as long as they need it, if they meet other coverage criteria.

The settlement is expected to affect thousands, and possibly millions, of Medicare beneficiaries with chronic health problems like Parkinson’s or Alzheimer’s disease, stroke, multiple sclerosis and spinal cord injuries. It could also help families, as well as the overburdened Medicare budget, delay costly nursing home care by enabling seniors to live longer in their own homes.

“Under this settlement, Medicare policy will be clarified to ensure that claims from providers are reimbursed consistently and appropriately and not denied solely based on a rule-of-thumb determination that a beneficiary’s condition is not improving,” said Fabien Levy, a spokesman for the U. S. Department of Health and Human Services, which includes the Medicare program.

The lawsuit was filed by the Center for Medicare Advocacy and Vermont Legal Aid on behalf of four Medicare patients and five national organizations, including the National Multiple Sclerosis Society, Parkinson’s Action Network and the Alzheimer’s Association. A tentative settlement had been reached in October and on Jan. 24 a federal judge in Vermont approved the deal.

For seniors getting skilled services at home under a doctor’s order, the settlement means Medicare’s home health coverage has no time limit, Margaret Murphy told lawyers attending the annual meeting of the National Academy of Elder Law Attorneys in Washington, D. C., shortly after the then-tentative settlement was announced.

The coverage “can go on for years and years, if your doctor orders it,” said Ms. Murphy, the center’s associate director, who added that patients must be homebound (though not bedbound) and need intermittent care — every couple of days or weeks – that can only be provided by a physical therapist, nurse or other trained health care professional. When physical therapy is provided as part of Medicare’s home health benefit, the therapy dollar limits may not apply.

The settlement ensures that nursing home residents will also get coverage for skilled care regardless of improvement, but does not change the duration, which is still limited to up to 100 days per “benefit period.” That begins when a patient is admitted as an inpatient to a hospital or a nursing home for skilled care and ends after 60 days without skilled care. The agreement preserves the requirement that they must also have spent at least three days as inpatients in a hospital.

Federal officials say the settlement is not a change in Medicare coverage rules, but that statement may surprise many beneficiaries and providers.

“If someone isn’t making progress, I say, ‘Listen, I’m sorry but Medicare’s not going to cover this so you can come in for a few more sessions but then I have to let you go,’ ” said Greg Babiec, a physical therapist and one of the owners of Evolve, a private therapy practice with offices in Manhattan and Brooklyn. He had not heard about the settlement.

Beneficiaries also often lose Medicare coverage for outpatient therapy because they hit the payment limit. But under the exceptions process Congress continued for another year, the health care provider can put an additional code on the claim that indicates further treatment above the $1,900 limit is medically necessary. When treatment costs reach $3,700, the provider can submit medical documentation to support a request for another exception to cover 20 more sessions. (A Medicare fact sheet provides some additional details, but has not been updated for 2013.)

In 2011, nearly five million seniors received therapy services at a cost of $5.7 billion, and about one out of every four received an exception to the then-$1,870 limit, according to the Medicare Payment Advisory Commission, an independent government agency that advises Congress.

Just a few hours before the settlement was approved, Rachel DeGolia learned that her 87-year-old father in Chicago was going to have to stop therapy because he stopped showing improvement — again.

“Every time he stops going to physical therapy, he starts to backslide in terms of his balance, his strength and his mobility,” said Ms. DeGolia, executive director of the Universal Health Care Action Network, a national advocacy group in Cleveland. His physical therapist did not know Medicare will cover therapy to prevent her father’s condition from getting worse.

Under the settlement, Medicare officials have until next January to straighten things out by notifying health care providers. Beneficiaries are not among those to be contacted, and so far the federal officials have not issued a formal statement on the settlement.

But patients don’t have to wait for their provider to get the official word, said Judith Stein, the lead attorney for the plaintiffs and executive director of the Center for Medicare Advocacy. “This isn’t a clandestine settlement,” she said.

The center’s Web site offers free “self-help” packets explaining how to challenge a denial of coverage that is based on the lack of improvement. Ms. Stein also advises beneficiaries to show a copy of the settlement — also available from the Web site — to your health care provider at your next physical therapy appointment if you are concerned about losing Medicare coverage. (If you follow this advice, let us know what happens.)

The Web site also explains how beneficiaries can request a review of their case if they received skilled nursing or therapy services in a skilled nursing facility, at home or as outpatients and were denied Medicare coverage because of a lack of progress after Jan. 18, 2011, when the lawsuit was filed.

Dean Lerner relied on the settlement last month to ensure that his brother-in-law would continue to receive Medicare physical therapy coverage.

“My brother-in-law in St. Louis suffers from Parkinson’s disease, and has for many years, and my sister is having a devil of a time helping him as his disease progresses,” said Mr. Lerner, a retired lawyer and state health official in Des Moines, who is also a Medicaid consultant.

A physical therapist teaches his brother-in-law to stand, turn and use a walker and maintain what little strength he still has. But because his condition hasn’t improved, the therapist said Medicare would not pay for additional sessions.

“But for my being an attorney, the outcome may well have been very different, and that shouldn’t be,” he said. “Why should you have to fight?”

Read More..

DealBook: Osborne Promises More Regulatory Power to Split Up British Banks

LONDON – British regulators will have the power to split up banks that fail to separate risky trading activity from retail banking, George Osborne, the country’s chancellor of the Exchequer, said on Monday.

As part of an overhaul over how the country’s banks operate, the British finance minister said regulators would be able to forcibly separate firms that failed to maintain a division between their retail banking and investment banking units.

The so-called ring-fencing of consumer deposits from risky trading activity is an effort to reduce the exposure to the wider British economy if one of the country’s largest banks goes bust.

Many of Britain’s largest banks have been engulfed in a series of scandals, and Mr. Osborne said the public was right to be angry over abuses in the country’s financial industry.

The spotlight is now focused on the Royal Bank of Scotland, which is expected to announce a settlement over the manipulation of a key benchmark rate as early as this week.

The bank, in which the government holds an 82 percent stake after providing a bailout, is said to be facing a fine of more than $650 million and a guilty plea against an Asian subsidiary related to the manipulation of the London interbank offered rate, or Libor.

Mr. Osborne said troubling behavior by those in Britain’s financial industry was unacceptable.

“Irresponsible behavior was rewarded, failure was bailed out, and the innocent – people who have nothing whatsoever to do with the banks – suffered,” Mr. Osborne said in a speech in Bournemouth, on the south coast of England.

During the recent financial crisis, a number of British banks, including the Lloyds Banking Group and Northern Rock, received multibillion-dollar bailouts after they ran into trouble because of exposure to risky assets.

To reaffirm the separation between retail and investment banking divisions, Mr. Osborne said on Monday that banks would have to appoint different senior managers to oversee each division. The new powers to forcibly split up banks are in response to fears that firms would try to find ways around dividing their retail and investment banking operations.

“No more rewards for failure. No more too big to fail. No more taxpayers forking out for the mistakes of others,” Mr. Osborne said.

Critics of the planned changes, however, say the separation of banks’ operations will make it harder for them to raise capital and provide financial support to British companies.

“This will create uncertainty for investors, making it more difficult for banks to raise capital, which will ultimately mean that banks will have less money to lend to businesses,” Anthony Browne, chief executive of the British Bankers’ Association, a trade body criticized for its role in the Libor scandal, said in a statement.

The changes, which form part of new banking legislation being submitted to Parliament on Monday, mirror similar efforts in the United States and Europe to reduce the effect of banks’ risky trading operations on the broader economy. The so-called Volcker Rule, which forms part of the Dodd-Frank Act and would prohibit banks from making risky bets with their money, is also nearing regulatory approval in the United States.

In Britain, authorities are going a step further by dividing the Financial Services Authority, the country’s financial regulator, into two separate units, as part of the widespread reforms.

In April, oversight of the country’s banks will be returned to the Bank of England, the central bank, while a new consumer protection agency will monitor market abuse.

The changes come after a series of recent settlements by British banks over illegal activity.

HSBC and Standard Chartered have agreed to pay a combined fine of more than $2 billion to American authorities related to money laundering allegations. Barclays reached a $450 million settlement with United States and British regulators in June related to the manipulation of Libor. And, in total, many of Britain’s largest banks have been required to pay billions of dollars of penalties after inappropriately selling loan insurance to customers.

“Our country has paid a higher price than any other major economy for what went so badly wrong in our banking system,” Mr. Osborne said on Monday.

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IHT Rendezvous: In Villages, Praying for the Souls of Tibetan Self-Immolators

BEIJING — Since November, when winter began in the high Tibetan Plateau, thousands of Tibetan villagers have been gathering daily to pray for the souls of the nearly 100 Tibetans who have burned themselves to death in protest over Chinese rule, in a show of widespread support for the self-immolators among ordinary people, according to witness testimony from a person recently returned from the region.

In traditional winter prayer meetings in villages, they gather to chant “Om mani padme hum,” Tibetan Buddhism’s most important mantra, which speeds a soul toward a good reincarnation, said the person, who witnessed a meeting in the Tibetan region of Qinghai Province in China.

The meetings are a sign of support for the self-immolators and point to widespread dislike among ordinary Tibetans for repressive policies in the region that have turned it into an “open-air prison,” said one ethnic Tibetan police officer in Lhasa, quoted by the witness.

The witness cannot be identified because of the high risk of persecution by the Chinese authorities. But the reliable account of ongoing, severe repression and resentment among Tibetans confirms other reports from the Tibet Autonomous Region or from Tibetan regions in Chinese provinces, where the authorities have been cracking down as they try to stop the spread of the self-immolations.

Chinese courts last week sentenced eight Tibetans for helping self-immolators, The Associated Press reported. One man was sentenced to death with a two-year reprieve, and others were sentenced to between 3 years and 12 years in jail, according to Xinhua, the state news agency.

The detail and content of the grass-roots prayer meetings is new.

“The meetings are a traditional thing to do during the winter and are held daily in different villages, and last three days,” the witness said. They are known in Chinese as “fahui,” or dharma meetings, which are also Buddhist law meetings.

“People drive on motorbikes for long distances, 50 or 60 kilometers, to whichever village is holding a prayer meeting. It’s mostly adults, and they are anywhere between 16 and over 80 years old. As soon as they can drive a motorbike, they’ll go,” the person said.

“Around 1,000 people may attend, often going from one meeting to another without returning home.”

“Their aim is for each meeting to have chanted ‘Om mani padme hum’ 100 million times. There’s no question that they regard the self-immolators as very great, and believe that with the help of their prayers, they will come back as powerful and blessed people,” said the person, who confessed to having reservations about the self-immolations.

Yet, “It’s extremely moving. Because if the self-immolations really were a mistake, how could they get so much support and sympathy from ordinary people?”

As my colleague Jim Yardley reports from India, where many Tibetans live in exile, some there are questioning the self-immolations.

The witness confirmed that, saying: “There is a feeling among some Tibetans,” especially monks or those in the religious hierarchy, “that the Dalai Lama needs to say something to stop it.”

Yet Tibetans who are deeply unhappy with Chinese rule are constrained in how they can protest.

“The problem is that Tibetans are Buddhists. The way things are there now, in other places, people might rise up and set off bombs. But they can’t do that because Buddhists believe you shouldn’t destroy other people’s happiness. So the only way they can protest is by killing themselves,” the person said.

And so the grass-roots support goes on.

The testimony from this person also confirmed reports of a very harsh crackdown under way in Lhasa, seat of the Jokhang, Tibet’s holiest temple, and the Potala Palace, the former home of the Dalai Lama, whom Tibetans revere and who has lived in exile since fleeing the Chinese in 1959.

The crackdown, in response to the self-immolations that began not long after an uprising in Lhasa was crushed in 2008, has turned Tibet into “an open-air prison,” said an ethnic Tibetan police officer. Like some other ethnic Tibetan police officers, he was considering resigning his post, he said.

“Lhasa used to be a sacred place for Buddhism. Now it’s a sacred place for Marxism-Leninism,” he said. “Every day there are meetings where leaders both big and small tell you that maintaining stability,” or “weiwen,” in Chinese, “is the most important thing, what the main tasks in Lhasa are. Lhasa is no longer a Buddhist sacred place,” he added.

“Lhasa is stuffed with police, every 10 paces there are several. I am growing to hate my own work. It’s really not possible to keep doing it. Some have already resigned,” he told the witness.

The crackdown includes forbidding ethnic Tibetans from the outlying regions, like Qinghai or Sichuan Provinces, which lie outside Tibet proper, from traveling to Tibet, and it is strictly enforced at airports and other transport nodes. Ethnic Han Chinese, however, can pass, effectively making Tibet out of bounds for many Tibetans.

Any Tibetan from outside the region wishing to travel to Lhasa must have a “sponsor” in the city working for the government, the witness said. They must surrender their identity cards and be photographed. Uniformed and plainclothes police officers and military patrol heavily in the city, trying to stop self-immolations.

Barring ethnic Tibetans from outside Tibet, many of whom have traditionally made pilgrimages to Lhasa, means that hotels and other businesses in the city have suffered since last May, when they were ordered off bounds to such travelers. A petition is now circulating from hotel owners asking the government to compensate them financially, “or we will take our request higher.” For reasons of political sensitivity, the petition, which has been seen by this newspaper, cannot be discussed in detail.

It is also extremely difficult for ordinary ethnic Tibetans to get a passport, meaning they cannot travel overseas, the witness said. The person believes the government’s motive is to minimize accounts, like this one, of the harsh repression in the region.

“They don’t want Tibetans leaving the country and telling the world what’s happening there. Hundreds of people leaving and telling the world is very different from one or two,” the person said.

With the Lunar New Year approaching, the prayer meetings will soon be scaled back, as farm work and animal husbandry resume. For now, though, the villagers are praying hard for the souls of the dead, with millions of mantras circulating in the thin air of the plateau.

“They say, we want their lives to come back. We want world peace. They pray for Tibet to have peaceful and happy days, and the world, too,” the person said.

Said the police officer: “Living in this tightly controlled atmosphere is unbearable. There’s no feeling of happiness. But maybe it’s good this way, it may speed up the day when the situation has to change. But I don’t have the courage to self-immolate. Maybe after I retire I’ll go to Beijing and petition.”

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