Below is a Fact Sheet from New York Legal Assistance Group regarding your rights if you need to temporarily reduced your home care hours during the COVID-19 crisis.
Did Your MLTC Plan Ask You to Agree to Reduce Your Hours? Or do you WANT to Reduce your Hours During COVID-19 Emergency? You may want to temporarily reduce your current hours of home care—or even pause your current home care—to limit exposure to the coronavirus, or because you have help from family/friends who are home from work.
The NYS Department of Health issued a directive on April 23, 2020 titled, “COVID-19 Guidance: Voluntary Plan of Care Schedule Change.”
The directive says:
TIP: Tell your MLTC care manager if you want to reduce or pause your home care services – it is not enough to tell this to your home care agency or CDPAP Fiscal Intermediary. It will protect your rights to tell your MLTC plan. Normally, if you refuse services you risk being dis enrolled by your MLTC plan. But during the emergency, if you voluntarily reduce or pause your home care services, the MLTC plan cannot dis enroll you from the plan. But to protect your rights, tell your plan you are making this temporary change.
WHAT IF YOUR MLTC PLAN TELLS YOU SERVICES MUST BE REDUCED BECAUSE OF COVID? This is incorrect. You can say no. The State Guidance of April 23, 2020 does say that MLTC plans can reach out to you if they identify you as a candidate for a temporary change. However, the MLTC plan should only reach out to members who refused or cancelled home care services to discuss a temporary care plan. MLTC plans should not reach out to you about reducing or pausing your services:
SAY NO if the plan asks you to make a change in your hours, if you do not want the change they are proposing. And call your plan to request a “plan appeal” of the proposed reduction in services.
If you want a temporary change, your MLTC should prepare a temporary service plan for you to sign. Read it carefully to make sure it is what you want.
GET HELP! Call ICAN if your plan reduces your hours without your consent, or pressures you to agree to a reduction, or does not reinstate your old hours within 72 hours of your request, or says you will be dis enrolled (kicked out of the plan) because you paused your home care.
Call 1-844-614-8800 or email firstname.lastname@example.org