8/6/2020 Fair Hearing decision reversed MLTC's decision to reduce care hours in favor of AppellantRead NowThe Levy Law Firm is pleased to report the reversal of an adverse determination by Archcare, an MLTC, authorized to provide Home Health Aide Services.
The facts of the case are that my client's Home Health Care service were reduced on the alleged ground that "the service is not medically necessary". The services were reduced from 12 hours/day of personal care and 3 hours/day of cluster care for a total of 15 hours/day, to only 6 hours/day of cluster care. This reduction was drastic and very detrimental to the well-being of the client. Arlene Glotzer, the client's Daily Money Manager, contacted the Firm to oppose the unfair decision and strongly advocated for her client. During the Fair Hearing, Archcare failed to support it's position and the Firm supported the client's claim with an expert report, negating Archcare's position. The Decision and Order by the State of New York Department of Health, Commissioner's Designee, on 7/31/2020 completely reversed the adverse determination, reinstated ALL the Home Health Care services, effective within 10 days of receipt of the Order. |
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May 2022
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