Lawsuit Challenges Lack of Notice by Managed Care Plans for Reductions in Service

July 17, 2014

Yesterday’s New York Times described a class-action lawsuit just filed by NYLAG (New York Legal Assistance Group):  http://nyti.ms/W8LTLl.

The lawsuit challenges lack of adequate notice by “mainstream” managed care plans and MLTC (managed long-term care) plans before plans:

• Reduce hours of home care services

• Stop services altogether

• Deny a request for an increase in services.

The notices are often mere “authorization for services” with the plan of care, but they don’t state that this plan of care is a reduction from what the recipient had before.  This is illegal.

If you have clients whose hours have been reduced or stopped altogether, NYLAG asks that you please get in touch with their office right away.  

Even if you were able to resolve the case informally through advocacy, or formally through a hearing or internal appeal, NYLAG still wants to hear about these examples.   For everyone helped by a professional advocate, there is someone who didn’t have that representation, and your examples will help illustrate that there is a wider problem.  

Please send NYLAG copies of notices that announce a new “plan of care” or “authorization” if that plan of care gives less hours than the client had before, or notices to reduce or terminate home care services. Or send descriptions of cases where services were cut or stopped with no notice at all.   

Please send these items to:  vbogart@nylag.org  or jwertheimer@nylag.org  or rwallach@nylag.org.  

NYLAG urges  you to contact them even if you’re not sure whether what you’ve encountered counts as an example of what the suit alleges.