17 Civ. 003397 (E.D.N.Y)

On June 6, 2017, the New York Legal Assistance Group (“NYLAG”) filed a class action complaint against New York State Department of Health (“DOH”) in the Eastern District of New York on behalf of a class of Medicaid recipients who receive home health care through Managed Long Term Care Plans (“MLTCPs”) and depend on that home health care to live safely in their homes.  The case challenges DOH’s failure to protect MLTCP enrollees from reductions or terminations of their care without notice and a Fair Hearing when their MLTCPs close or stop operating in their counties of residence.

The case arises from the closure of a particular MLTCP in Suffolk, Nassau, and Westchester Counties.  DOH allowed this MLTCP to send out a misleading letter to enrollees about their rights during its closure.  The confusing letter caused some enrollees to switch MLTCPs at a loss of care, which put their safety at risk and also constituted a reduction in Medicaid benefits without due process.

DOH’s failure to establish a transition plan when an MTLCP closes places Medicaid enrollees at risk of reductions and terminations in care without notice or a Fair Hearing, in violation of the Medicaid Act and the Due Process Clause of the Fourteenth Amendment of the U.S. Constitution.  DOH’s conduct also violates the Americans with Disabilities Act and Section 504 of the Rehabilitation Act by placing MLTCP enrollees at an unnecessary and inappropriate risk of institutionalization.

NYLAG moved for certification of the class on July 3, 2017, and DOH has not yet filed an opposition to that motion.  On August 3, 2017, DOH filed an answer to the Complaint.  The parties are engaged in settlement discussions.  If the settlement discussions do not resolve the case, the case will proceed to discovery in the fall of 2017.

NYLAG Attorneys:  Jane Greengold Stevens, Elizabeth Jois, Ben Taylor, Stewart Dearing, and Paola Rivera.

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