MANAGED LONG TERM CARE FAIR HEARINGS

Medicaid Managed Fair hearings

Representing You At Fair Hearings in New York

The Law Office of Inna Fershteyn and Associates are experienced NY Elder Care attorneys who represent elderly clients at Fair Hearings for Managed Long Term Care Plans such as GuildNet, Senior Health Partners, Senior Whole Health and others to appeal determination to reduce clients Personal Care Services hours.

Pursuant to Section 22 of the New York State Social Services Law and Part 358 of Title 18 NYCRR Ms. Fershteyn appears with clients at fair hearings in New York City, before an Administrative Law Judge.

Protect Your Rights. Reverse The Determination to Reduce Personal Care Services With Our Help

Our elder care attorneys successfully argue and reverse the determination to reduce Personal Care Services as under sections of 18 NYCRR 505.14(b) because relevant Agencies frequently fail to meet the following reasons:

(1) the clients medical, mental, economic or social circumstances have changed and the district determines that the personal care services provided under the last authorization or reauthorization are no longer appropriate or can be provided in fewer hours than they were previously;

(2) a mistake occurred in the previous personal care services authorization;

(3) the client refused to cooperate with the required assessment of services;

(4) a technological development renders certain services unnecessary or less time consuming;

(5) the client can be more appropriately and cost- effectively served through other Medicaid programs and services;

(6) the clients health and safety cannot be assured with the provision of personal care services;

(7) the clients medical condition is not stable;

(8) the client is not self-directing and has no one to assume those responsibilities;

(9) the services the client needs exceed the personal care aides scope of practice;

(10) the client resides in a facility or participates in another program or receives other services which are responsible for the provision of needed personal care services.

Our experienced Fair Hearing attorneys and Managed Long term care lawyers successfully challenge New York City's efforts to reduce elderly clients personal care services, authorized under fee-for-service Medicaid.

My mother received a letter from Guildnet reducing her home attendant hours can Law Office of Inna Fershteyn represent us at Manager Long Term Care Fair Hearing?

If your elderly parent or grandparent received a letter from GuildNet, ElderServe, Health First or any other Long Term Care Medicaid Managed care plan, contact Law Office of Inna Fershteyn and associates immediately and schedule an individual Managed Long Term Care attorney consultation.  Our experienced Elder Care attorney will go over your individual case with you and explain how

What are some of the reasons why I might need a Fair Hearing?

  • Your Application for Public Assistance, Medical Assistance, Supplemental Nutrition Assistance Program, Home Energy Assistance Program (HEAP) benefits or Services is denied, and you do not agree with this decision.
  • You applied for Public Assistance, Medical Assistance , SNAP or Services, and more than 30 days have passed. You have not been told yet if your Application has been approved or denied. For some adults applying for Public Assistance, the decision may take up to 45 days.
  • You applied for Medical Assistance as a disabled person, and more than 90 days have passed. You have not been told yet if your Application has been approved or denied.
  • You have been told that, due to your abuse of Medical Assistance, you must get your medical care from one main provider (Recipient Restriction Program). You do not agree with this decision.
  • You are getting Public Assistance, Medical Assistance, SNAP or Services, and you have been told that your case is being closed. You do not agree with this decision.
  • Your local department of social services uses part of your Public Assistance to pay directly for your bills such as heat, rent, utilities or child care (restricted payments). You do not agree with this.
  • You ask for more assistance or services for a special need and you are told you cannot get it. You do not agree with this.
  • You are getting Public Assistance or SNAP each month and you are told that you will be getting less. You do not agree with this.
  • You believe that the amount of HEAP benefits you received is incorrect.
  • You are told that you are able to work (employable), and you do not agree with this.
  • You think the amount of your Public Assistance or SNAP is wrong.
  • You are getting Medical Assistance, but you have to pay part of the cost. You think your share is too much.
  • You are getting Medical Assistance and you disagree with a local agency decision about enrollment in a Managed Care Plan.
  • You are getting Medical Assistance and are enrolled in a Managed Care Plan and disagree with the plan’s decision about your health benefits or services under the plan

Contact Us Today

You may contact the Law Office of Inna Fershteyn at (718) 333-2394 or contact us online for a consultation request today.