Hi everyone – this comes to us from Medicaid Matters NY (MMNY) regarding a report on the pattern of arbitrary and illegal reductions in hours of home care services.
As many of you know, members of MMNY have been working on a report to shed light on the findings of an extensive study of fair hearing decisions on reductions of personal care and Consumer Directed Personal Assistance services hours by Managed Long Term Care (MLTC) plans. The report, issued along with the NY Chapter of the National Academy of Elder Law Attorneys, identifies every fair hearing decisions concerning reductions by MLTC plans posted in the NYS public archive, during the last seven months of 2015. The more than 1000 decisions reveal a pattern of arbitrary and illegal reductions in hours of home care services. While most members win these hearings, the fear is that for every member who had the wherewithal to request, travel to, and present their case at a hearing, undoubtedly there were many who could not. The report calls on the State to restore services for these vulnerable New Yorkers, stop plans from engaging in these illegal reductions, and improve its oversight of these private plans spending public dollars.
The report was featured in a story in today’s NYTimes: http://www.nytimes.com/2016/07/21/nyregion/insurance-groups-in-new-york-improperly-cut-home-care-hours.html
A copy of the report is attached and it is available on the MMNY website on our “policy and advocacy” page.
Thank you to the authors of the report – Valerie Bogart, Amy Lowenstein, Rebecca Novick, and Carol Santangelo – and to the people who contributed extensive time to reviewing fair hearing decisions. Their names are listed in the report; the MMNY members who contributed were Elizabeth Berka and Adam Prizio.
As always, please let me know if you have any questions.
Lara Kassel
Coordinator
Medicaid Matters NY
c/o Schuyler Center for Analysis and Advocacy
540 Broadway
Albany, NY 12207
518-463-1896 x124
[email protected]
www.medicaidmattersny.org