Not long ago a few residents received some disturbing news–the New York Medicaid support that they counted on to survive was being cut back. Many of these community members had severe disabilities, needing help with every aspect of their life, from dressing and bathing to eating and traveling. Many seniors and those with disabilities receive help from at-home care workers around the clock so that they are able function in the least invasive setting possible despite their challenges.
Yet, in an apparent effort to recoup funds given back to federal officials following an overbilling case that settled in November, the New York City Human Resources Administration decided to alter the way some personal care was provided to residents. In particular “split-shift” at home care was curtailed. This care is provided to those who need help 24 hours a day, with two different care workers each taking a 12 hours shift. In it’s place, the city wanted to provide just a single care worker who lived with the Medicaid recipient.
New York City Medicaid Lawsuit
Following the city’s administrative change, a class-action lawsuit was filed by affected residents seeking to halt the alterations. As reported by the New York Times last week, a judge recently granted the plaintiff’s request and stopped the rule changes–issuing a preliminary injunction. Preliminary injunctions are granted before a full hearing on the merits of the case and only in situations where the judge finds that the moving party has a”substantial likelihood’ of succeeding when the full hearing takes place.
In this case, the judge found not only was improper notice given to affected residents, but federal law was likely violated in the slashing of personal care support. The court pointed out that while financial concerns were at the root of the rule change, services could not be cut to residents in contravention of the law. Of course, the law itself can be changed. However, until that occurs the state is obligated to provide the care to which each resident is legally entitled.
This case is a lesson about the inherent volatility of Medicaid support in tough budget times. However, it is also a testament to the way that the legal rules surrounding the program can be used to protect services provided to those in need. These support programs are complex, with federal rules, state rules, and administrative guidelines stacked atop one another. That is why professional advice, like that provided by a New York Medicaid lawyer, are often crucial when working through the intricacies of the program.
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