The New York Times reported this week on a settlement reached by New York City officials which may have implications for all local seniors who rely on New York Medicaid services to stay in their homes. The problem began when New York City officials agreed to pay $70 million to settle a claim alleging Medicaid fraud. The case stemmed from federal accusations that the city approved Medicaid expenses for in-home care when cheaper nursing home care was available. The federal government pays for half of Medicaid expenses and so federal officials can bring suit if they believe that cities or states are not following Medicaid rules resulting in payment increases.
While the settlement ends the specific legal matter, our New York Medicaid attorneys know that there may be other repercussions as a result of the agreement. Medicaid rules can be complex, and cities and states are loath to make costly violations of those rules. As a result of this latest settlement, many observers have noted that city officials are taking protective measures to ensure better compliance with those sometimes harsh rules. Those measures may involve cutting at-home services to seniors who currently rely on them to stay living on their own.
Specifically, advocates explain that the city has now told at least a hundred elderly residents that it will reduce and in some cases discontinue currently available 24-hour at-home services. Much of this assistance–like bathing and toileting–is the only thing that is keeping residents in their own homes and out of nursing homes. There is a real fear that cut-backs in this care will ultimately force residents out of their homes. Dozens of disabled advocacy groups voiced that very concern in a letter to federal officials this week. The plea stated that “denials or reduction of services are the default position of an agency fearful of sanctions and audits.”
For their part city officials acknowledge that they are becoming more vigilant about violating Medicaid rules. However, those rules are most often set by state officials, and any complaints about the requirements should be directed at the statehouse. Speculation remains rampant about changes that state officials may make in the coming months to the Medicaid system. The policies that they set with relation to the program dictate who qualifies for care and what care they can receive. Local residents should be sure to pay close attention to these developments to better understand how it might apply in their own case. However, at the end of the day, local residents are always best served by taking their long-term care plans into their own hands. Our New York elder law attorneys know that the earlier families plan, the better. When at-home care is desired–and it almost always is–the only surefire way to make it available is visiting with professionals well before the actual care is needed and arranging financial affairs to ensure the resources will be there at the right time.
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