State Medicaid Cutbacks Must Still Follow Federal Law, Says Dallas Elder Lawyer
Waxahachie, TX (Law Firm Newswire) October 10, 2012 - On September 5, 2012, a preliminary injunction was issued by a judge on cutbacks threatened for New York state’s Medicaid coverage.
At issue was whether New York had violated federal law by cutting back on personal care funding to individuals on Medicaid. Some state residents who were receiving shifts of multiple at-home care workers to cover each 24-hour period were instead only allotted a single aide who would reside with the disabled person. The preliminary injunction effectively halted the cut-back, determining that the plaintiffs had a “substantial likelihood” of succeeding as their case progressed, but the case has yet to be decided.
"Legal challenges are growing across the county," said Dallas elder law attorney John Hale. "Currently, the federal government provides Medicare funds to each state, with the assumption that those states will follow the spending guidelines, but both state and federal officials can alter, to some degree, what can be changed, within limits."
Plaintiffs argued that the state altered its guidelines to an extent that it may have crossed the federal limit line, hence the lawsuit. Many people think of Medicaid as a federal program, but it is a joint federal and state program. While Medicare provides insurance for seniors, Medicaid is there for home caregiving and nursing home care.
The evidence was strong against New York state's illegal termination of services, Judge Shira Scheindlin, stated in the injunction ruling; proper notice was allegedly not provided to the residents. The injunction ordered the city to stop terminating and/or reducing care without a medical order from a doctor or if a declaration had been submitted that there had been a mistake in requesting said care.
"While states can alter some guidelines," says Hale, "They must stay within the law. Changes to Medicaid law can only be made by policymakers."
New York City's Human resources Administration issued a short statement which said, in part, that they disagree with the injunction, but for now, will comply. The next move is up to them – they can appeal the ruling, fight the suit, or settle with plaintiffs.
This is just one of several issues with New York Medicaid; in January 2011, the U.S. attorney’s office accused the city of over billing Medicaid to the tune of tens of millions of dollars. New York City settled the lawsuit for $70 million in late 2011.
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