New York State Medicaid Update - Important Notice - June 2014
If you receive Medicaid and have been accepted for care by a home care agency known as a certified home health agency (or “CHHA”), this notice contains information you may want to know about how the CHHA should provide care based on your doctor’s orders.
The CHHA provides you with home health services, which may include aide services, according to a written plan of care. Your doctor establishes your plan of care and also reviews it from time to time to make sure it still meets your needs. Your doctor must review your plan of care as often as your medical condition requires but at least once every 60 days. The CHHA must promptly alert your doctor if your medical condition changes so that your doctor can decide whether to change your plan of care.
The CHHA must inform you, in advance, about the care you will receive. The CHHA must also inform you, in advance, of any changes to the plan of care before the change is made. This includes telling you, in advance, of the following:
- the doctor who ordered the change in the plan of care;
- that the CHHA provides care as ordered by your doctor; and
- that if you are not happy with the change in your care that your doctor ordered, you should talk about it with your doctor.
If your doctor decides that the CHHA should not make the change in your care that you are unhappy about, your doctor should let the CHHA know about this by writing a new doctor’s order. If you have asked for a State fair hearing, you can take this new doctor’s order to the fair hearing and show it to the judge. The judge will decide whether the CHHA should provide you with that care.
