New York Expands Due Process Rights for Medicaid MLTC Recipients

by David Goldfarb Goldfarb Abrandt Salzman & Kutzin LLP

New York State’s 2014 budget bill  added additional due process protections to persons receiving home care under the Medicaid Managed Long Term Care (MLTC) Program.  The bill makes clear that when an MLTC provider determines to eliminate or reduce home care services and a fair hearing is timely requested, then the recipient must continue to receive the services unreduced, even if it is at the end of an authorization period.

Subdivision 8 of section 365-a of the social services law is amended to make clear that when a determination is made by a non-governmental entity the recipient is entitled to the same notice and procedural due process rights as if such determination were made by a government entity, including a right to a fair hearing and aid continuing, without regard to expiration of the prior service authorization.

Section 4403-f of the public health law is amended to make it clear that Social Services Section 365-a(8) applies to MLTC decisions.