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Is Marijuana Addictive? The Debate Continues.

Marijuana is the most commonly used recreational drug in the United States. As of 2012, over 29 million Americans admit to regularly using marijuana. More than 98 million Americans age 14 and older have admitted to using marijuana at least once.

The possession, use, or sale of marijuana became illegal in many countries in the early 20th century. At that time, many of them began to enact laws against the cultivation, possession, and sale of marijuana. Countries began to arrest and prosecute people for using marijuana while other countries have either reduced enforcement of marijuana laws or have legalized the use of marijuana completely. In the United States, there are at least thirteen states that have legalized marijuana for medicinal use and have set-up regulatory systems to oversee its safe sale and access to medical marijuana patients.

The degree to which marijuana is addictive continues to be the subject of great debate. Opponents to legalization of marijuana believe that marijuana is both psychologically and physically addictive. They argue that long-term use of marijuana and its immediate cessation can cause moderate to severe irritability, sleeplessness, decreased appetite, and anxiety. Moreover, symptoms can begin within about a day following abstinence, and last for about a week to ten days.

Proponents of legalizing marijuana use claim that marijuana is no more addictive then a cup of coffee. Still other proponents believe that marijuana has little if any addictive properties even in cases involving long-term use of marijuana.

While critics of marijuana use claim that marijuana has been associated with health hazards like lung and throat cancer, proponents of marijuana use point to medical studies that show that medical marijuana has been successful in treating the symptoms of glaucoma, migraines, arthritis and HIV/AIDS.

Notwithstanding, both the critics and proponents of marijuana seem to agree that people with addictive personalities can develop an obsessive attraction to the drug, which is neither healthy nor desired. However, what must be considered is that addictive personalities can get addicted to almost anything they consume and enjoy. In this regard, we can say that obsessive and addictive personalities share a predisposition to marijuana addiction. However, this does not mean, that marijuana is addictive to the general population and the medical research seems to be bearing this out.

So what does the medical community have to say about marijuana? You might be surprised to learn that most current medical research has been supportive of the use of marijuana in treating many types of terminal illnesses including Alzheimer’s disease. With respect addiction, medical studies have not substantiated any inherent addictive features attributable to the normal use of marijuana.

Marijuana use will continue to be a source of controversy in the years to come. What we do know today is that marijuana is neither toxic nor lethal, nor does it pose any greater risks then either tobacco, caffeine or alcohol.

Finally, many are asking whether the benefits of marijuana substantially outweigh it’s potential for addiction. More and more states are answering this question in the affirmative.

For More Information on marijuana, addiction, medical marijuana, state and federal laws and more, visit Gottrouble.com


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Patients Preferring Organic Verses Synthetic Medical Marijuana

Patients Preferring Organic Verses Synthetic Medical Marijuana

Synthetic THC, the active ingredient in marijuana, is now legally available by medical prescription and is sold in pill form by many major retail pharmacies. While synthetic THC is widely available in its new easy-to-take pill form, a growing number of medical marijuana patients still prefer organically grown marijuana and believe that synthetic marijuana fails to measure up to the medical benefits found in organically grown medical marijuana.

One reason for patients preferring organic THC to the synthetic form is that it takes over an hour for synthetic THC to take effect, while organically grown medical marijuana takes only minutes. Synthetic THC is also more expensive. Thirty single doses of synthetic THC can cost up to $800.00 at the neighborhood pharmacy, which by comparison, is nearly ten times the cost of organically grown medical marijuana. Furthermore, synthetic THC is not without notable but mild side effects.

It is also widely believed that organically grown medical-grade marijuana is much more benign in nature then its synthetic counterpart. In fact, patients that have suffered with migraines, cancer, and glaucoma, report to have medicinally benefited from the use of organically grown medical marijuana. Unlike synthetic THC, medical marijuana is completely organic and has been used medicinally for thousands of years without any major contraindications. In fact, a growing number of physicians are now recommending medical marijuana verse its synthetic counterpart to their patients.

Recent patient trials compared the effectiveness of medical marijuana in cancer patients who were otherwise unresponsive to more traditional forms of therapy. Patients were asked to choose between inhaled medical marijuana and the synthetic pill. The patients preferred organically grown medical marijuana to its synthetic counterpart.

Other studies have also shown a higher success rate among cancer patients who were smoking medical marijuana than among patients who were given THC capsules for the treatment of nausea – a common complaint that is usually secondary to a patient’s chemotherapy treatment. Researchers in New Mexico found that inhaling medical marijuana was preferable to ingesting it in a majority of the patients surveyed. In addition, the California Board of Pharmacy has reported that inhaled medical marijuana and orally ingested THC produced similar results in patients. Notwithstanding, both patients and their physicians still rated medical marijuana as more effective than orally ingested synthetic THC.

Notwithstanding, whole patient populations continue to use medical marijuana in very significant numbers despite its illegality in many states and under federal law. The added risk of fines and the possibility of criminal prosecution are apparently worth it for the relief many patients are finding from organically grown medical marijuana.

So why are more doctors not prescribing organically grown THC to their patients? Physicians are still reluctant to prescribe any drug that is technically illegal under federal law and which has not approved by the Federal Drug Administration. The simple truth is that both doctors and their patients remain fearful of arrest and criminal prosecution but are more frequently accepting these risks because they believe that organically grown medical marijuana offers greater therapeutic relief and value then other forms of legal pain relief.

Since the federal government prohibits the use and possession of medical marijuana, even for medicinal purposes, patients are unnecessarily burdened and forced into using synthetic substitutes that many suspect lack much of the therapeutic effect and medical efficacy of organically grown medical marijuana.

Synthetic THC should remain a legal option for physicians and their patients. In the meantime pharmaceutical companies should continue their research into the medical benefits and risks associated with the intake of organically grown medical marijuana and the development of additional cannabis-based pharmaceuticals.


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Washington State – Medical Marijuana Laws

Washington is one of seventeen states that have effectively decriminalized the medical use of marijuana. Not surprisingly, the state has enacted strict oversight laws and commercial guidelines concerning the sale, purchase and use of medical marijuana through local marijuana dispensaries and clinics. Under Federal marijuana law, the use, whether medicinal or not, is still strictly prohibited.

Washington Chapter 69.51A RCW (PDF 34KB) Ballot Initiative — Approved by 59% of voters on Nov. 3, 1998
Effective: Nov. 3, 1998
Removes state-level criminal penalties on the use, possession and cultivation of marijuana by patients who possess “valid documentation” from their physician affirming that he or she suffers from a debilitating condition and that the “potential benefits of the medical use of marijuana would likely outweigh the health risks.”
Approved Conditions: Cachexia; cancer; HIV or AIDS; epilepsy; glaucoma; intractable pain (defined as pain unrelieved by standard treatment or medications); and multiple sclerosis. Other conditions are subject to approval by the Washington Board of Health.
Possession/Cultivation: Patients (or their primary caregivers) may legally possess or cultivate no more than a 60-day supply of marijuana. The law does not establish a state-run patient registry.
Amended: Senate Bill 6032 (PDF 29KB)
Effective: 2007 (rules being defined by Legislature with a July 1, 2008 due date)

Amended:Final Rule based on Significant Analysis
Effective: Nov. 2, 2008
Approved Conditions: Added Crohn’s disease, Hepatitis C with debilitating nausea or intractable pain, diseases, including anorexia, which result in nausea, vomiting, wasting, appetite loss, cramping, seizures, muscle spasms, or spasticity, when those conditions are unrelieved by standard treatments or medications.
Possession/Cultivation:A qualifying patient and designated provider may possess a total of no more than twenty-four ounces of usable marijuana, and no more than fifteen plants. This quantity became the state’s official “60-day supply” on Nov. 2, 2008.

For more information about Washington State medical marijuana, laws, enforcement and penalties visit GotTrouble.com.

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Field Sobriety Tests and Driving Under The Influence of Marijuana

Field Sobriety Tests and Driving Under The Influence of Marijuana

In every state in the union it is unlawful to operate a motor vehicle while under the influence of marijuana. In driving under the influence of marijuana cases, the prosecution must prove beyond a reasonable doubt that the driver was so impaired at the time of driving, that the driver could not operate a motor vehicle safely.

Unlike alcohol, there is no accurate way to measure THC levels (the active ingredient in marijuana) since it is difficult to know when the actual intake of marijuana actually occurred and because a person can test positive for marijuana for up to thirty days after first using marijuana. Measuring alcohol is a different story. Most jurors understand that a blood alcohol level of over 1.0 usually means the driver was “per se” too impaired to drive a motor vehicle safely. Marijuana is a different story.

Without a viable and reliable way to measure the level of THC in a driver, the police must resort to using other forms of testing such as conducting field sobriety tests on the driver. These tests are by nature very subjective and problematic to administer fairly. Field sobriety tests are used by the officer to determine if, in his or her professional police opinion, the driver was so impaired he or she could not operate a motor vehicle safely and therefore should be arrested for driving under the influence of marijuana.

The driver is usually ordered out of the vehicle to perform field sobriety tests. While standing on the side of the road, an officer puts the driver through a series of balance, coordination, and mental acuity tests. While each jurisdiction uses its own field sobriety tests, there are some common tests used by practically all police agencies.

Balance tests

The driver is usually asked to stand on one foot and lean back with their eyes closed. Another balance favorite is asking the driver to walk an “imaginary line” usually in darkness of night. Innocent factors effecting balance tests include the actual location and conditions surrounding the test (on the roadside with cars speeding by), the lighting (dark, poorly lighted), the actual surface and pitch of the test area (loose gravel or dirt, uneven or slanted), the weather (cold, rainy, windy, snowy), and the drivers shoes (boots, heels, stiff dress shoes) all play a role in determining the accuracy of the testing. Interestingly, the loss of balance is not usually associated with being under the influence of marijuana. Notwithstanding, law enforcement continues to use these forms of tests to determine sobriety and safe driving.

Coordination tests

The driver, using one hand, is usually asked to touch each finger with the thumb, going from the index finger to the pinky finger and then back down again. This apparently demonstrates dexterity and the ability to follow instructions. Other popular coordination tests include asking the driver to count backwards while touching the nose with the tip of the index finger and while the drivers eyes are shut closed. Not only are these tests difficult to do when completely sober, the test is affected by the actual test conditions and the officers own ability to give clear and concise directions. All too often the officer does a poor job of explaining exactly what is required. Keep in mind that not everyone has the same degree of dexterity.

Mental tests

Reciting the alphabet, counting backwards from a random number (“count backwards from 73 to 57” or “count backwards from 100 by 7s”) is all part of testing a driver’s mental acuity and capacity to focus on a task. Most experienced criminal defense attorneys can point out that these tests are often misleading since they are usually administered late at night, while the subject is nervous, tired and under interrogation. Further, the officer’s opinion of poor performance on these field sobriety tests does not necessarily indicate the driver was so impaired he could not operate a vehicle safely.

Unlike the drunk driver, the driver under the influence of marijuana does not typically display the same types of deficits in balance, coordination and mental acuity that are so often produced by alcohol intoxication.

Just because driving under the influence of marijuana is more difficult to prove with any degree of certainty, one should not underestimate the penalties if one actually gets convicted of the offence. The penalties are serious and a conviction for driving under the influence of marijuana can result in fines, jail time and loss of driving privileges.

For more information on driving under the influence of marijuana and state penalties and laws visit GotTrouble.com (link to: http://gottrouble.com/legal/criminal/marijuana/index.html)

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Arizona – Medical Marijuana Laws

Arizona has effectively decriminalized the medical use of marijuana. Not surprisingly, the state has enacted strict oversight laws and commercial guidelines concerning the sale, purchase and use of medical marijuana through local marijuana dispensaries and clinics. Under Federal marijuana law, the use, whether medicinal or not, is still strictly prohibited.

Arizona Ballot Proposition 200 — Approved by 65% of voters on Nov. 5, 1996
Effective: Dec. 6, 1996 [Not Active]
Measure changed sentencing for drug offenders, requiring those who commit violent crimes to serve full sentences without parole, and diverting non-violent drug offenders into treatment. Prop 200 also permitted doctors to prescribe schedule I controlled substances, including marijuana, to treat a disease or to relieve pain and suffering in seriously ill and terminally ill patients. Under federal law, however, marijuana is considered an illegal drug and physicians are prohibited from writing prescriptions for illegal drugs. The use of the word “prescribe” instead of “recommend” is the reason that Prop 200 is not considered to make medical marijuana legal in Arizona.
Not Amended: House Bill 2518, which was signed by the governor on Apr. 21, 1997, sought to repeal Proposition 200’s medical marijuana provision by requiring the Food and Drug Administration (FDA) to first approve marijuana before allowing state physicians to prescribe it. The bill was placed on the Nov. 3, 1998 ballot as a referendum, where voters rejected it by a vote of 57% to 43%.

For more information about Arizona medical marijuana, laws, enforcement and penalties visit GotTrouble.com.

What Is CBD? – I Hear It Is A Safe Alternative To Medical Marijuana

What Is CBD? – I Hear It Is A Safe Alternative To Medical Marijuana – Does Not Get You High – But Still Has The Medicinal Benefits Of Medical Marijuana.

There is a derivative of medical marijuana that has been getting a great deal of media attention. It is called CBD and it is not psychoactive, which means it does not make you high even though it comes from the active ingredient of marijuana known as THC. It is called CBD and the sale and distribution is legal in most states. No serious adverse side effects have been reported.

The science behind the drug is that it works by indirectly stimulating the cannabinoid receptors in the brain. The drug has shown to lessen pain, inflammation, psychosis, anxiety and spasm without the high. It also possesses anti-oxidant properties that can limit neurological damage after stroke, trauma, or neurodegenerative diseases like Alzheimer’s. It has shown to also be effective in the suppression of tumors in colon cancer patients.

While medical marijuana is considered by many scientific organizations to be a legitimate remedy for pain management, it still has a bad reputation and the sale and distribution of medical cannabis is still considered a felony under Federal law.

The CBD drug is commonly consumed in the form of oil, which is inhaled through a vaporizer. It is also being consumed as a nose spray. For those patients that want the relief marijuana provides, but not the high or sedating effect, CBD is quickly becoming the patient’s choice for relief. It is now being considered the non-toxic, non-psychoactive alternative to medical marijuana. In addition, there are studies on CBD that indicate there are major therapeutic effects for people that suffer from anxiety, schizophrenia, stroke, epilepsy and cardiovascular disease.

The most effective dosage levels are still being determined as many of the studies conducted thus far have been on lab animals, although several studies dating back to the 90’s have looked at the effect on humans with positive outcomes. With the legalization of medical and recreational marijuana in many states, more federal dollars are being channeled toward the study of medical marijuana and its effects. This is a good thing. So far, while the results are far from comprehensive, it wouldn’t be an exaggeration to say they are encouraging.


For more information on Medical Marijuana 




Are The New Super-Flu Vaccines Safe For Seniors? What Is The Vaccination Injury Compensation Program?

Q.  I am a caregiver for my 88 year old mother who is two years post-stroke and is extremely frail. We are approaching the flu season and I have read that there is a new and improved vaccine that was developed especially for seniors. The problem, however, is that I am suspicious of drug company claims and I am especially concerned about unintended and potentially dangerous side effects, which for elders like my mom, can have devastating consequences. Is being vaccinated for a super flu vaccine worth the risk?

A. It’s flu season and much is being made in the media today about the effectiveness of flu vaccines. Vaccines have always been controversial. The decision whether to vaccinate or not means one is forced to choose between getting your Super-Flue vaccine and the possible adverse effects it can cause or gamble on getting the flu which can be life-threatening for elders. Either way, if you are a senior, or a caretaker, the choice you make whether or not to vaccinate should be an informed one.

Seniors At Substantial Risk

One of the highest-risk groups for complications from the flu are persons over the age of 65. In fact, seniors account for 50-60 percent of hospitalizations that occur as a result of the flu and nearly 90 percent of all flu-related deaths in the United States.

In the beginning of 2010, a high dose vaccine was approved by the FDA called Fluzone High Dose. Fluzone High Dose was specially developed for seniors over the age of 65. According to the drug company experts, the 2014-2015 flu season has influenza vaccines available which some drug companies claim protect elders against the influenza “A” and influenza “B” virus. These vaccines however have their risks and downsides. The first downside is cost. The super flue vaccine is twice the price of the standard dose vaccine and while some drug companies claim the higher dose vaccine offers twice the protection against the flu, there may also be a higher incident of serious adverse effects from them.

Possible Adverse Effects of Flu Shots

Both the swine flu (H1N1) vaccine and the more traditional flu shot have been associated with causing the following types of side effects: Guillain-Barre syndrome (GBS), severe allergic reaction, chronic inflammatory demyelinating polyneuropathy (CIDP), acute brachial neuritis and disseminated encephalomyelitis (ADEM). Other less severe conditions include elder complaints of redness, pain and swelling at the injection site, muscle aches, fever and malaise, all of which were reported to subside in less then a week.

A growing number of highly respected physicians, however, state that the high dose flu vaccines being promoted may in fact not be as safe as drug companies claim. If this is true, and the high dose flu vaccines are not as effective or safe as claimed, then why would one, especially an elder, risk the increased risk of getting an adverse effect? Some physicians go as far as claiming these high dose flu vaccines have little-to-no scientific evidence that a higher dose of the antibody result in decreased flu and health complications. In fact, some medical studies suggest that the vaccine is ineffective for all age groups, not just for seniors. Further, the number of adverse effects after vaccination is higher than those of other lower dose vaccinations. To compare the clinical efficacy of high dose flue vaccines to that of normal-dose flu vaccines in elderly adults, you can review the following clinical trial study.

Finally, if you or a loved one has suffered a serious illness as a result of a vaccine you should know there are laws and remedies that protect consumers from dangerous vaccines and their side effects. In fact, compensation may be available through the National Vaccine Injury Compensation Program. This is a no-fault system that was created to provide compensation for any person who is injured by a vaccine. Under this program, you will be provided with compensation if you suffer one of their recognized side effects within their specified amount of time after being vaccinated and the government will usually pay the attorney fees should you bring such a case under the programs requirements.

Both My Fiancé And Myself Are Physically Disabled. Is It True That Our SSA Benefits Will Be Reduced If We Get Married?

Q: Both my fiancé and myself are physically disabled. Is it true that our SSA benefits will be reduced if we get married?

My fiancé and I both receive SSI benefits and the combined amount allows us to maintain our own residence and independence after many years of being dependent on family members for food and shelter. We both have disabilities that stem from birth defects so the likelihood of us being rehabilitated and being able to work is non-existent. We recently became engaged, however, we have been advised by SSA that one or both of our benefits will be reduced as a result of us getting married? Is this true, and if so, why does the SSA take a position so as to discourage marriage amongst those with disabilities? Why must we be forced to choose between marital happiness and the loss of income, which allows us to maintain our autonomy? I thought marriage was supposed to offer more security to individuals.

A: It is not uncommon for couples to exchange vows in order to take advantage of the tax deduction. Often the birth of a new baby is referred to as “our little tax deduction.” And the tax benefits continue for the blissfully betrothed when you throw in the mortgage interest deduction. Indeed, the many advantages of marriage were designed to make the institution more appealing. So, what to make of the seemingly arbitrary rule of the SSA in which benefits for a married couple, both of whom receive SSI and have no other income, amount to 25 percent less than the total they would receive if they were living together but not as husband and wife? (SSA website)*

Unfortunately, it is true that a married couple wherein both spouses receive SSI benefits will receive 25 percent less in total benefits than that of two individuals co-habitating. The reason for this is that the SSA takes into consideration one’s living arrangements. A person living with family will receive less benefit than a person living with a friend. The rationale behind this is they believe family members will contribute more to the needs of a SSI recipient such as food, healthcare and rent. Most likely the recipient is paying less than a fair market value share of rent. This is what is referred to as in-kind income. Likewise, a married couple will share income and expenses which allows them to live more cheaply than a single person. This is what is referred to as deemed income. It does seem egregiously unfair to individuals with disabilities but sometimes pragmatism wins out over romance. Something to think about before you say “I do.”





Understand Federal Health Insurance – Medicare Law Rules And Regulations

Quick Legal Reference Guide To Federal Law On Federal Health Insurance For The Aged And Disabled

The following laws will provide the federal rules and regulations with links to the relevant laws:

Subpart A [Reserved]

Subpart B—Medical Services Coverage Decisions That Relate to Health Care Technology

§405.201 Scope of subpart and definitions.
§405.203 FDA categorization of investigational devices.
§405.205 Coverage of a non-experimental/investigational (Category B) device.
§405.207 Services related to a noncovered device.
§405.209 Payment for a non-experimental/investigational (Category B) device.
§405.211 Procedures for Medicare contractors in making coverage decisions for a non-experimental/investigational (Category B) device.
§405.213 Re-evaluation of a device categorization.
§405.215 Confidential commercial and trade secret information.
Subpart C—Suspension of Payment, Recovery of Overpayments, and Repayment of Scholarships and Loans

General Provisions

§405.301 Scope of subpart.
Liability for Payments To Providers or Suppliers and Handling of Incorrect Payments

§405.350 Individual’s liability for payments made to providers and other persons for items and services furnished the individual.
§405.351 Incorrect payments for which the individual is not liable.
§405.352 Adjustment of title XVIII incorrect payments.
§405.353 Certification of amount that will be adjusted against individual title II or railroad retirement benefits.
§405.354 Procedures for adjustment or recovery—title II beneficiary.
§405.355 Waiver of adjustment or recovery.
§405.356 Principles applied in waiver of adjustment or recovery.
§405.357 Notice of right to waiver consideration.
§405.358 When waiver of adjustment or recovery may be applied.
§405.359 Liability of certifying or disbursing officer.
Suspension and Recoupment of Payment to Providers and Suppliers and Collection and Compromise of Overpayments

§405.370 Definitions.
§405.371 Suspension, offset, and recoupment of Medicare payments to providers and suppliers of services.
§405.372 Proceeding for suspension of payment.
§405.373 Proceeding for offset or recoupment.
§405.374 Opportunity for rebuttal.
§405.375 Time limits for, and notification of, administrative determination after receipt of rebuttal statement.
§405.376 Suspension and termination of collection action and compromise of claims for overpayment.
§405.377 Withholding Medicare payments to recover Medicaid overpayments.
§405.378 Interest charges on overpayment and underpayments to providers, suppliers, and other entities.
§405.379 Limitation on recoupment of provider and supplier overpayments.
Repayment of Scholarships and Loans

§405.380 Collection of past-due amounts on scholarship and loan programs.
Subpart D—Private Contracts

§405.400 Definitions.
§405.405 General rules.
§405.410 Conditions for properly opting-out of Medicare.
§405.415 Requirements of the private contract.
§405.420 Requirements of the opt-out affidavit.
§405.425 Effects of opting-out of Medicare.
§405.430 Failure to properly opt-out.
§405.435 Failure to maintain opt-out.
§405.440 Emergency and urgent care services.
§405.445 Renewal and early termination of opt-out.
§405.450 Appeals.
§405.455 Application to Medicare+Choice contracts.
Subpart E—Criteria for Determining Reasonable Charges

§405.500 Basis.
§405.501 Determination of reasonable charges.
§405.502 Criteria for determining reasonable charges.
§405.503 Determining customary charges.
§405.504 Determining prevailing charges.
§405.505 Determination of locality.
§405.506 Charges higher than customary or prevailing charges or lowest charge levels.
§405.507 Illustrations of the application of the criteria for determining reasonable charges.
§405.508 Determination of comparable circumstances; limitation.
§405.509 Determining the inflation-indexed charge.
§405.511 Reasonable charges for medical services, supplies, and equipment.
§405.512 Carriers’ procedural terminology and coding systems.
§405.515 Reimbursement for clinical laboratory services billed by physicians.
§405.517 Payment for drugs and biologicals that are not paid on a cost or prospective payment basis.
§405.520 Payment for a physician assistant’s, nurse practitioner’s, and clinical nurse specialists’ services and services furnished incident to their professional services.
§405.534 Limitation on payment for screening mammography services.
§405.535 Special rule for nonparticipating physicians and suppliers furnishing screening mammography services before January 1, 2002.
Subparts F-G [Reserved]

Subpart H—Appeals Under the Medicare Part B Program

§405.800 Appeals of CMS or a CMS contractor.
§405.803 Appeals rights.
§405.806 Impact of reversal of contractor determinations on claims processing.
§405.809 Reinstatement of provider or supplier billing privileges following corrective action.
§405.812 Effective date for DMEPOS supplier’s billing privileges.
§405.815 Submission of claims.
§405.818 Deadline for processing provider enrollment initial determinations.
Subpart I—Determinations, Redeterminations, Reconsiderations, and Appeals Under Original Medicare (Part A and Part B)

§405.900 Basis and scope.
§405.902 Definitions.
§405.904 Medicare initial determinations, redeterminations and appeals: General description.
§405.906 Parties to the initial determinations, redeterminations, reconsiderations, hearings and reviews.
§405.908 Medicaid State agencies.
§405.910 Appointed representatives.
§405.912 Assignment of appeal rights.
Initial Determinations

§405.920 Initial determinations.
§405.921 Notice of initial determination.
§405.922 Time frame for processing initial determinations.
§405.924 Actions that are initial determinations.
§405.925 Decisions of utilization review committees.
§405.926 Actions that are not initial determinations.
§405.927 Initial determinations subject to the reopenings process.
§405.928 Effect of the initial determination.

§405.940 Right to a redetermination.
§405.942 Time frame for filing a request for a redetermination.
§405.944 Place and method of filing a request for a redetermination.
§405.946 Evidence to be submitted with the redetermination request.
§405.948 Conduct of a redetermination.
§405.950 Time frame for making a redetermination.
§405.952 Withdrawal or dismissal of a request for a redetermination.
§405.954 Redetermination.
§405.956 Notice of a redetermination.
§405.958 Effect of a redetermination.

§405.960 Right to a reconsideration.
§405.962 Timeframe for filing a request for a reconsideration.
§405.964 Place and method of filing a request for a reconsideration.
§405.966 Evidence to be submitted with the reconsideration request.
§405.968 Conduct of a reconsideration.
§405.970 Timeframe for making a reconsideration.
§405.972 Withdrawal or dismissal of a request for a reconsideration.
§405.974 Reconsideration.
§405.976 Notice of a reconsideration.
§405.978 Effect of a reconsideration.

§405.980 Reopenings of initial determinations, redeterminations, and reconsiderations, hearings and reviews.
§405.982 Notice of a revised determination or decision.
§405.984 Effect of a revised determination or decision.
§405.986 Good cause for reopening.
Expedited Access to Judicial Review

§405.990 Expedited access to judicial review.
ALJ Hearings

§405.1000 Hearing before an ALJ: General rule.
§405.1002 Right to an ALJ hearing.
§405.1004 Right to ALJ review of QIC notice of dismissal.
§405.1006 Amount in controversy required to request an ALJ hearing and judicial review.
§405.1008 Parties to an ALJ hearing.
§405.1010 When CMS or its contractors may participate in an ALJ hearing.
§405.1012 When CMS or its contractors may be a party to a hearing.
§405.1014 Request for an ALJ hearing.
§405.1016 Time frames for deciding an appeal before an ALJ.
§405.1018 Submitting evidence before the ALJ hearing.
§405.1020 Time and place for a hearing before an ALJ.
§405.1022 Notice of a hearing before an ALJ.
§405.1024 Objections to the issues.
§405.1026 Disqualification of the ALJ.
§405.1028 Prehearing case review of evidence submitted to the ALJ.
§405.1030 ALJ hearing procedures.
§405.1032 Issues before an ALJ.
§405.1034 When an ALJ may remand a case to the QIC.
§405.1036 Description of an ALJ hearing process.
§405.1037 Discovery.
§405.1038 Deciding a case without a hearing before an ALJ.
§405.1040 Prehearing and posthearing conferences.
§405.1042 The administrative record.
§405.1044 Consolidated hearing before an ALJ.
§405.1046 Notice of an ALJ decision.
§405.1048 The effect of an ALJ’s decision.
§405.1050 Removal of a hearing request from an ALJ to the MAC.
§405.1052 Dismissal of a request for a hearing before an ALJ.
§405.1054 Effect of dismissal of a request for a hearing before an ALJ.
Applicability of Medicare Coverage Policies

§405.1060 Applicability of national coverage determinations (NCDs).
§405.1062 Applicability of local coverage determinations and other policies not binding on the ALJ and MAC.
§405.1063 Applicability of laws, regulations and CMS Rulings.
§405.1064 ALJ decisions involving statistical samples.
Medicare Appeals Council Review

§405.1100 Medicare Appeals Council review: General.
§405.1102 Request for MAC review when ALJ issues decision or dismissal.
§405.1104 Request for MAC review when an ALJ does not issue a decision timely.
§405.1106 Where a request for review or escalation may be filed.
§405.1108 MAC actions when request for review or escalation is filed.
§405.1110 MAC reviews on its own motion.
§405.1112 Content of request for review.
§405.1114 Dismissal of request for review.
§405.1116 Effect of dismissal of request for MAC review or request for hearing.
§405.1118 Obtaining evidence from the MAC.
§405.1120 Filing briefs with the MAC.
§405.1122 What evidence may be submitted to the MAC.
§405.1124 Oral argument.
§405.1126 Case remanded by the MAC.
§405.1128 Action of the MAC.
§405.1130 Effect of the MAC’s decision.
§405.1132 Request for escalation to Federal court.
§405.1134 Extension of time to file action in Federal district court.
§405.1136 Judicial review.
§405.1138 Case remanded by a Federal district court.
§405.1140 MAC review of ALJ decision in a case remanded by a Federal district court.
Subpart J—Expedited Determinations and Reconsiderations of Provider Service Terminations, and Procedures for Inpatient Hospital Discharges

§405.1200 Notifying beneficiaries of provider service terminations.
§405.1202 Expedited determination procedures.
§405.1204 Expedited reconsiderations.
§405.1205 Notifying beneficiaries of hospital discharge appeal rights.
§405.1206 Expedited determination procedures for inpatient hospital care.
§405.1208 Hospital requests expedited QIO review.
Subparts K-Q [Reserved]

Subpart R—Provider Reimbursement Determinations and Appeals

§405.1801 Introduction.
§405.1803 Contractor determination and notice of amount of program reimbursement.
§405.1804 Matters not subject to administrative and judicial review under prospective payment.
§405.1805 Parties to contractor determination.
§405.1807 Effect of contractor determination.
§405.1809 Contractor hearing procedures.
§405.1811 Right to contractor hearing; contents of, and adding issues to, hearing request.
§405.1813 Good cause extension of time limit for requesting a contractor hearing.
§405.1814 Contractor hearing officer jurisdiction.
§405.1815 Parties to proceedings before the contractor hearing officer(s).
§405.1817 Hearing officer or panel of hearing officers authorized to conduct contractor hearing; disqualification of officers.
§405.1819 Conduct of contractor hearing.
§405.1821 Prehearing discovery and other proceedings prior to the contractor hearing.
§405.1823 Evidence at contractor hearing.
§405.1825 Witnesses at contractor hearing.
§405.1827 Record of proceedings before the contractor hearing officer(s).
§405.1829 Scope of authority of contractor hearing officer(s).
§405.1831 Contractor hearing decision.
§405.1833 Effect of contractor hearing decision.
§405.1834 CMS reviewing official procedure.
§405.1835 Right to Board hearing; contents of, and adding issues to, hearing request.
§405.1836 Good cause extension of time limit for requesting a Board hearing.
§405.1837 Group appeals.
§405.1839 Amount in controversy.
§405.1840 Board jurisdiction.
§405.1842 Expedited judicial review.
§405.1843 Parties to proceedings in a Board appeal.
§405.1845 Composition of Board; hearings, decisions, and remands.
§405.1847 Disqualification of Board members.
§405.1849 Establishment of time and place of hearing by the Board.
§405.1851 Conduct of Board hearing.
§405.1853 Board proceedings prior to any hearing; discovery.
§405.1855 Evidence at Board hearing.
§405.1857 Subpoenas.
§405.1859 Witnesses.
§405.1861 Oral argument and written allegations.
§405.1863 Administrative policy at issue.
§405.1865 Record of administrative proceedings.
§405.1867 Scope of Board’s legal authority.
§405.1868 Board actions in response to failure to follow Board rules.
§405.1869 Scope of Board’s authority in a hearing decision.
§405.1871 Board hearing decision.
§405.1873 [Reserved]
§405.1875 Administrator review.
§405.1877 Judicial review.
§405.1881 Appointment of representative.
§405.1883 Authority of representative.
§405.1885 Reopening a contractor determination or reviewing entity decision.
§405.1887 Notice of reopening; effect of reopening.
§405.1889 Effect of a revision; issue-specific nature of appeals of revised determinations and decisions.
Subparts S-T [Reserved]

Subpart U—Conditions for Coverage of Suppliers of End-Stage Renal Disease (ESRD) Services

§§405.2100-405.2101 [Reserved]
§405.2102 Definitions.
§405.2110 Designation of ESRD networks.
§405.2111 [Reserved]
§405.2112 ESRD network organizations.
§405.2113 Medical review board.
§405.2114 [Reserved]
§§405.2131-405.2184 [Reserved]
Subparts V-W [Reserved]

Subpart X—Rural Health Clinic and Federally Qualified Health Center Services

§405.2400 Basis.
§405.2401 Scope and definitions.
§405.2402 Rural health clinic basic requirements.
§405.2403 Rural health clinic content and terms of the agreement with the Secretary.
§405.2404 Termination of rural health clinic agreements.
§405.2410 Application of Part B deductible and coinsurance.
§405.2411 Scope of benefits.
§405.2412 Physicians’ services.
§405.2413 Services and supplies incident to a physician’s services.
§405.2414 Nurse practitioner, physician assistant, and certified nurse midwife services.
§405.2415 Services and supplies incident to nurse practitioner, physician assistant, certified nurse midwife, clinical psychologist, or clinical social worker services.
§405.2416 Visiting nurse services.
§405.2417 Visiting nurse services: Determination of shortage of agencies.
Federally Qualified Health Center Services

§405.2430 Basic requirements.
§405.2434 Content and terms of the agreement.
§405.2436 Termination of agreement.
§405.2440 Conditions for reinstatement after termination by CMS.
§405.2442 Notice to the public.
§405.2444 Change of ownership.
§405.2446 Scope of services.
§405.2448 Preventive primary services.
§405.2449 Preventive services.
§405.2450 Clinical psychologist and clinical social worker services.
§405.2452 Services and supplies incident to clinical psychologist and clinical social worker services.
Payment for Rural Health Clinic and Federally Qualified Health Center Services

§405.2460 Applicability of general payment exclusions.
§405.2462 Payment for RHC and FQHC services.
§405.2463 What constitutes a visit.
§405.2464 Payment rate.
§405.2466 Annual reconciliation.
§405.2467 Requirements of the FQHC PPS.
§405.2468 Allowable costs.
§405.2469 FQHC supplemental payments.
§405.2470 Reports and maintenance of records.
§405.2472 Beneficiary appeals.

Seven Signs Of ElderAbuse

An elderly person who has Alzheimer’s disease or the onset of dementia is particularly at risk for neglect since they are often unable to adequately communicate the abuse to others. Families therefore must keep a sharp and attentive eye for signs of elder abuse and be diligent in promptly reporting it to the authorities.

Here are seven signs of possible elder abuse:

1. A sudden shift in the elders personality, usually accompanied by episodes of confusion, irritability and fear.

2. Look for evidence of tension between the caregiver and your elderly loved one. Being short and curt with the elder demonstrates a hostile atmosphere. The caregiver is supposed to be caring and agreeable – not abrupt and confrontational!

3. A common sign is when the caregiver’s refuses to allow others to visit the elderly person or decides for the elder which person(s) are allowed to visit them.

4. Look for new and unusual physical marks on the elder such as bedsores, bruises, burn marks or scrapes.

5. Look for a steady loss in weight resulting from malnutrition and dehydration. It is not unusual to have assisted living facilities cut costs by buying inexpensive and easy to prepare foods that lack nutrition.

6. If the caretaker and the elderly person are alone together most of the time.

7. The elder’s physical appearance and hygiene declines sharply. Also look for soiled bedspreads and sheets all of which points to a lack of attention and personal care for the elder.


Social Security Claiming

How To Report Elder Abuse In Los Angeles County

How To Report Elder Abuse In Los Angeles County:

The Los Angeles Adult Protective Services (APS) is a 24-hour public service program that investigates all reported at-risk elder abuse complaints.

Types of referrals include physical, sexual or financial abuse, isolation, neglect, or self-neglect. If you suspect someone is the victim of elder abuse contact the following social services elder hotlines:

Los Angeles County

Community & Senior Services

3333 Wilshire Blvd. Suite 400

Los Angeles, CA  90010

24-Hour Elder Abuse Reporting Hotline:

(877) 477-3646

APS Mandated Reporter Hotline:

(M-F, 8:30-5:00) (888) 202-4248

Legal Duty To Report Elder Abuse (MANDATORY REPORTERS)

As a matter of public policy, certain types of individuals and institutions that assume complete or partial care for an elderly person are compelled by law to report suspected incidents of elder abuse. These people and institutions are known as “mandatory reporters” and include: Health care practitioners, local law enforcement agencies, clergy, employees of county adult protective services agencies, and employees of financial institutions.

Los Angeles County Includes The Following Cities and Townships:

Los Angeles, Pasadena, Santa Monica, Monrovia, Pomona, Long Beach, South Pasadena, Compton, Redondo Beach, Whittier, Azusa, Covina, Alhambra, Arcadia, Vernon, Glendale, Huntington Park, La Verne, Hermosa Beach, Sierra Madre, Claremont, Inglewood, Burbank, San Fernando, Glendora, El Monte, Manhattan Beach, San Gabriel, San Marino, Avalon, Beverly Hills, Monterey Park, El Segundo, Culver City, Montebello, Torrance, Lynwood, Hawthorne, South Gate, West Covina, Signal Hill, Maywood, Bell, Gardena, Palos Verdes Estates, Lakewood, Baldwin Park, Cerritos, La Puente, Downey, Rolling Hills, Paramount, Santa Fe Springs, Industry, Bradbury, Irwindale, Duarte, Norwalk, Bellflower, Rolling Hills Estates, Pico Rivera, South El Monte, Walnut, Artesia, Rosemead, Lawndale, Commerce, La Mirada, Temple City, San Dimas, Cudahy, Bell Gardens, Hidden Hills, Palmdale, Hawaiian Gardens, Lomita, Carson, Rancho Palos Verdes, Flintridge, La Habra Heights, Westlake Village, Agoura Hills, West Hollywood, Santa Clarita, Diamond Bar, Malibu, Calabasas, Burbank, Toluca Lake, Altadena, Northridge, Silverlake, Downey, Montebello, Azusa, Duarte, Monrovia, Santa Monica, Hollywood, Encino, Tarzana, Sherman Oaks, San Fernando Valley, Woodland hills, Studio City, San Marino, South Pasadena, Culver City, Porter Ranch, Van Nuys, Valley Glen, Valley Village, Whittier, and  Hollywood


Courtesy of The Elder Law Center of San Fernando Valley.

One-Third Of All Americans Are In Debt Collection – What Debt Collectors Can’t Do To You

According to the Urban Institute, 1 in 3 adults, 77 million Americans in total, are currently in debt collection. This means that one-third of our nation must deal with the emotional pressure of mounting debt and receiving letters and calls from debt collectors on a regular basis.

According to the report,  Nevada has nearly 50% of their residents in debt collection. Consider that while so many Americans are suffering from unrelenting debt, the wealthiest of the wealthy, roughly 600 people, less then one-hundreth of one percent own more then 50% of this nations wealth. This growing disparity in wealth carries with it the potential for both a civil and financial collapse. President Lincoln’s words that “a house divided cannot stand” applies not only to physical slavery but to economic slavery as well.

In the meantime, Americans need to know their rights. According to the Fair Debt and Collection Practices Act, debt collectors must comply with the law when contacting you. If collectors violate these rules, you can take legal action.

Collectors are prohibited from actions like these:

1. Call repeatedly or continuously, which is considered per se harassment. [15 USC 1692d] § 806(5).

2. Use obscene, profane, or abusive language.

3. Using harassing language. [15 USC 1692d] § 806(2)

4. Call you during late or early morning hours. Call before 8:00 am or after 9:00 pm [15 USC 1692c] § 805(a)(1)

5. Adding on any extra fees that your original credit or loan agreement doesn’t allow. [15 USC 1692f] § 808(1)

6. Call at times the collector knew or should know was inconvenient for you.

7. Calls at these times are considered harassment. [15 USC 1692c] § 805(a)(1)

8. Use or threaten to use violence if you don’t pay the debt.

9. Collectors can’t threaten violence against you. [15 USC 1692d] § 806(1)

11. Collectors are prohibited from threatening to sue you, garnish wages, take property, cause job loss, or ruin your credit when the collector cannot or does not intend to take the action. [15 USC 1692e] § 807(5)

Elder Rights – Online Resources And Advocates For The Elderly – Medicare, Medicaid, Social Security, Elder Care, Legal Advocates, V.A. Benefits….

This online list of elder rights resource links provide descriptive information on important elder issues involving: Social Security, Medicare, Medicaid, Hospice, Nursing Homes, Assisted Living, Caretakers, Elder Legal Advocates, Elder Housing, and Elder Advocates.

American Association of Retired Persons – 
www.aarp.org – Provides a variety of elder topics including Social Security and Medicare. They promote elder advocacy at the national level.

Alzheimer’s Association -
www.alz.org – A research, education and support organization that provides a nationwide network of 24/7 support centers to those inflicted with Alzheimer’s disease and their families.

American Hospice Foundation -
www.americanhospice.org – Provides information and support programs for the terminally ill and their grieving families.

Center for Medicare Advocacy -
www.medicareadvocacy.org– Provides attorneys, paralegals, nurses, and technology specialists. The Center offers a wide variety of Medicare information such as self-help guides and updates.

Families USA -
www.familiesusa.org – Organization provides information on affordable health and long-term care and includes a directory of related sites that cover Medicaid and managed care. Also offers a wide range of materials to helpful elder care organizations.

The Hospice Patients Alliance -
www.hospicepatients.org –The Hospice Patients Alliance a nonprofit organization committed to serving the hospice patients, their families and caregivers.

Last Acts -
www.lastacts.org – A non-line community and resource site that is devoted to improving end-of-life care by delivering educational programs involving professional caregivers, educators and citizens.

MealCallwww.MealCall.org – Also known as “Meals-On-Wheels” and offers resources to local senior meal delivery services and offers direct financial support by providing online contact assistance between volunteer organizations and the people that need their services.

Medicare Rights Center
 www.medicarerights.org – A nonprofit center committed to ensuring that our elderly population with disabilities receives appropriate and affordable health care. The site provides helpful information and resources on Medicare and its health care programs.

Association of Professional Geriatric Care Managers – www.caremanager.org – Committed to the development, advancement, and promotion of humane and dignified care for the elderly.

National Association of Senior Move Managers -
 www.nasmm.org – Committed to a smooth transition for seniors who are moving from their home to a senior housing community.

National Citizens Coalition for Nursing Home Reform -
www.nccnhr.org – Dedicated to improving the quality of life of nursing home residents.

National Health Law Project – www.healthlaw.org –Provides health care advocacy and information for low-income elders. Offers litigation support, training and consulting services.

National Family Caregivers Association -
www.nfcacares.org – Provides public awareness and advocacy in reducing the disparity between a caregiver’s quality of life with that of the general public.

Social Security Claimants Representatives Organization – www.nosscr.org – Provides training and information to attorneys specializing in Social Security disability law.

National Partnership For Women & Families -
www.nationalpartnership.org – Provides caregiving information on important federal laws impacting caregivers.

National Private Duty Association -
www.privatedutyhomecare.org – This association serves the information needs of providers of private duty home care, which includes non-medical home care services.

National Senior Citizens Law Center -
www.nsclc.org – Nation wide legal advocates for low-income elderly individuals and persons with disabilities including areas dealing with: Age Discrimination, Americans with Disabilities Act, Medicaid, Medicare, Nursing Homes, Older Americans Act, Pension Rights and Social Security.

Nurse Competence in Aging -
www.GeroNurseOnline.org – Organization is dedicated to the quality of health care to seniors by advancing knowledge in geriatric competence.

Trial Lawyers for Public Justice -
www.tlpj.org – Trial Lawyers for Public Justice is dedicated to using trial lawyers’ skills and resources to advance the public good including those legal rights dealing with the elderly.

United Seniors Health Cooperative –www.unitedseniorshealth.org – The site contains information about long-term care insurance, Medicare, Medicaid and Medigap insurance and offers helpful publications.

The A2Z Senior Supersite -
www.SeniorHospitality.com – This site provides links and resources to quality Senior Hospitality providers offering housing, health and wellness services and products.

MyZiva -
www.myziva.net – Evaluates and compares nursing home care facilities across the country.

SeniorScape -
www.seniorscape.com – This site offers free and elder care resources to the public and serves as an interactive forum for elder care professionals and service providers.

Bet Tzedek Legal Services -
www.bettzedek.org/aboutus.html – A Los Angeles non-profit law firm that provides free legal services to financially struggling seniors.

Association of Healthcare Medical Lawyers -
www.healthcare-medlawyers.org – Their goal is fight healthcare providers who commit fraud in both the Medicare system as well as the commercial business sectors.

Senior-Source – www.seniorresource.com – Offers housing options for seniors, which include financial and insurance counseling.

Social Security Handbook -
www.ssa.gov/OP_Home/handbook/ssa-hbk.htm – Federal government site offers downloadable and printable copies of the official Social Security Handbook and includes timely updates to the information they offer.

Veterans Administration – www.va.gov – The official government Veterans Affairs site and includes information, resources and links to key V.A. information resources.

Medicare and Medicaid Services – 
www.cms.hhs.gov – This is the official government site for Medicare, Medicaid and the Children’s Health Insurance Programs.

Medicare General Information -
www.medicare.gov – Site includes Medicare a huge database of nursing homes, service directories and offers downloadable booklets on Medicare services.

Social Security Administration -
www.ssa.gov – This is the official government site for the administration of Social Security programs and benefits.

Collection Agency Law Firms Churn Debt And Abuse Debtors By The Thousands…

In an economy in which the poor are getting poorer and the rich are getting richer, the potential for unethical and illegal collection tactics tend to rise exponentially. The attack on the poor is growing more vicious due to overly-aggressive law firm collection agencies.

On June 14, 2014, the federal government announced it sued Frederick J. Hanna & Associates, a Georgia-based collection law firm that sues debtors for stale debts that are assigned to them by banks, debt purchasers and major credit card companies.

The complaint alleges that Frederick J. Hanna operated like a mill, processing nearly 400,000 suits since 2009. The suit alleges that the collection lawyers effectively rubber-stamped civil collection complaints without performing even the minimum of due diligence which are required of them under the law. In effect, the legal process has been radically automated resulting in non-lawyers acting in the capacity of lawyers for purposes of collecting debts in volume and often without regard to the legal rights of debtors.

The lawsuit alleges that the companies collection lawyers were processing lawsuits in mass.  In one instance, according to the govrnment release, nearly 140,000 lawsuits, an average of about 1,300 a week were being processed by a single lawyer. Consider the anguish this one lawyer has caused in a single day. According to one consumer facing a collection law suit, “It’s like a brave new world – lawyers are using technology to press the screws deeper into people like us causing those in poverty to be punished even more for their economic status….It feels like the legal system is on the side of creditors and debtors are viewed as undesirable losers….”

Don’t Accept Unfair and Illegal Collection Practices. Report Collection Predators To The Authorities. Be Informed and Know Your Rights.

The following are considered Abusive and Illegal Collection Practices:

*Collectors cannot call you at unreasonable hours: The law presumes that 8:00 am -9:00 pm is reasonable. Any time outside this range is presumed to be unreasonable and therefore unlawful in most states.

*Collectors cannot call you at work, so long as you first inform them that your employer does not permit personal phone calls.

*Collectors cannot communicate with other people about your debt or even that you owe a debt – while they can look for you – they cannot mention or imply that it is about a debt owed.

*Collectors cannot threaten to sue you or take other legal action (like repossession or wage garnishment) unless they actually intend on doing so. (Also known as the “put-up or shut-up rule)

*Collectors cannot engage in “harassment” in order to collect a debt. The following prohibited conduct has been considered harassment per se in most states:

*Cannot threaten you that your credit will be ruined if you fail to pay your debt.

*Cannot threaten harm in any way– either directly or indirectly

*Cannot use profanity

*Cannot call you repeatedly (Most states prohibit more then once a day)

*Cannot give the false impression that you are speaking with a lawyer. Similarly, they cannot send you a letter that falsely gives the impression it’s from a law office.

*Cannot request that you write a post-dated check. (A five-day post is allowed in some states)

*Cannot falsely insinuate that by not paying your debt you have committed a crime. (Being delinquent on a debt is not a criminal offence.)

*Cannot communicate with you if you have referred them to your attorney and have given them the name, address and phone number of the attorney.

*Cannot communicate with you by postcard.

*Cannot make false threats of suit or legal action without actually taking that action.

The most important thing to remember is to never take collection calls or letters personally. Almost everyone, one time or another will run into financial trouble. Sometimes that trouble can be caused by a lost job, illness, divorce, accident or a hundred other miserable troubles people are forced to endure in times of financial trouble.

Have you been the victim of outrageous and abusive collection harassment? We want to know. Share your story. We will do our best to keep people informed of the ongoing abuses people have to endure in these times of economic trouble.

Click Here To Learn More About Collection and Consumer Rights




Love The People Who Treat You Right – Pray For The Ones That Don’t…


There comes a time in your life,
when you walk away from all the drama and the people who create it.
You surround yourself with people who make you laugh.
Forget the bad, and FOCUS ON THE GOOD.

Love the people who treat you right,
pray for the ones who don’t.

Life is too short to be
Falling down is a part of life,
getting back up is living.
Jose N Harris