Carter Wrenn posted on February 19, 2010 21:44
For Immediate Release:
Contact Tim Rogers 919-848-3450 (office) 919-961-3555 cell
February 19, 2010
Today, the Honorable Donald W. Overby, Administrative Law Judge with the North Carolina Office of Administrative Hearings, entered an Order enjoining the Department of Health and Human Services from recalculating hours of services for Medicaid recipients of Personal Care Services using a new mathematical formula specifically designed by the Department to drastically cut in-home service hours with no individual assessment. If the injunction sought by the Association for Home & Hospice Care of North Carolina (“AHHC”) had not been entered, the Department intended to send out nearly 37,000 letters to the elderly, disabled, and chronically ill that receive these in-home services cutting average hours by over 40%.
Judge Overby heard three days of testimony on the injunction motion, including the testimony of nurses, family members, and caregivers, who told the judge that these drastic cuts would cause tremendous harm to the individuals who depend on these services and that many would be forced into hospital emergency rooms and more expensive institutional care.
AHHC filed this lawsuit because the Department was ignoring the medical needs of recipients and not following the law. In his Order, Judge Overby expressed great concern about testimony by the Medicaid Director Dr. Craigan Gray that his agency is bound to follow the law only if it has the money! As the Order states: “The state surely cannot and would not tolerate such a position by its corporate and individual citizens.” It is AHHC’s position that Medicaid must follow the law in all cases and not continue perpetuating untruths about the numbers of people ineligible for the services.
“We could not be more delighted with the court’s decision in ruling on behalf of 37,000 PCS patients” said Tim Rogers, CEO of the Association for Home and Hospice Care. “The court stated emphatically medical necessity is the key to who should receive care – and that has been our point all along. In the decision, Judge Overby commented that the faces and plights of individual PCS recipients and their medical needs could not be ignored.
“There has been a lot of political rhetoric from DHHS Secretary Lanier Cansler and Medicaid officials claiming they were not cutting care to any patient who needed it. In fact, they are cutting care to needy, qualified patients not based on medical need but a math formula without a physical examination of a single patient by the State.
It’s just common sense a bureaucrat sitting at a computer in Raleigh can’t tell if an eighty year grandmother who is legally blind, diabetic, and an amputee say, in Manteo, is sick and needs home care services. “The injunction halts Secretary Cansler’s plan. On behalf of the patients cared for by North Carolina’s home care industry, we are grateful for this decision and look forward to the full hearing on April 26. Today, the voices of North Carolina’s elderly, disabled, and chronically ill citizens were heard.”
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