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Guildnet Closes Its Doors

On August 21, 2018, Guildnet CEO, Alan R. Morse, notified employees that the company will be closing its doors as of December 1, 2018, leaving New Yorkers in need of managed long-term care (MLTC) services at a disadvantage. The Guildnet program was designed to offer therapeutic/medical care, home healthcare services, case management, and medical equipment to those who qualify and will be in need of the provided services for a minimum of 120 days. Guildnet announced that by January 1st of 2019, all medical services to their 8,211 managed long-term care members will be terminated. United Healthcare, who until recently offered a partial MLTC plan, will also be pulling out of several counties in up-state New York by February of 2019, affecting nearly 1,500 enrollees who are said to be notified of these changes by November.

Guildnet’s managed long-term care members will be given a 90-day grace period to enroll in a new plan. Members who fail to switch care programs before the deadline will be automatically assigned to a care plan.  After enrolling in a new plan, Guildnet members will be able to switch their plan within 120 days should their new plan be deemed insufficient. The new care plan must honor the same service plan that the former Guildnet member received in the past and allow members to be seen by the same providers unless otherwise agreed to. The new care plan must perform a comprehensive care evaluation.

The void left by Guildnet and other MLTC providers leaving can bring about uncertainty about the continuity of home care services. If you or a loved one has been affected by the closing of Guildnet or the disruption of service from another MLTC association, it is imperative that you contact an experienced New York Medicaid and elder law attorney, who can guide you through the process. The attorneys at Hobson-Williams, P.C. are dedicated to representing clients with diligence and compassion. For an initial consultation, contact the New York Medicaid attorneys at Hobson-Williams, P.C. by calling 866-825-1LAW.

 

New York City Settles Allegations of False Medicaid Claims

The case of Ohlmeyer ex rel. United States of America v. City of New York, a whistleblower action brought by the federal government against the city of New York has been settled. The 2012 complaint accused the city’s education department of submitting false claims to Medicaid for counseling services to special education students, and as of January 2014, New York City has agreed to pay $1.37 million in an official settlement.

The complaint, charged that New York City’s Department of Education (DOE) knowingly billed Medicaid for psychological counseling services for individual special education students who did not receive two monthly counseling session, the minimum number required for payment, between 2001 to 2004.

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