** This article has been revised from its original version which was published on March…
Were Your Covered Hours of Care Reduced After Switching from Guildnet to a New MLTC? You May Be Eligible to Have Your Hours Restored.
Back in November 2016, we reported that managed long term care provider, Guildnet was no longer providing Medicaid services in Nassau, Suffolk or Westchester County.
Participants in Guildnet were left with transitioning to a new MLTC provider. In some cases, the participant was notified by the new MLTC that they would be receiving fewer hours of care than they did with Guildnet. This resulted in a reduction of necessary and essential home cares services under Medicaid.
On September 29, 2017, the State issued a letter to approximately 3,000 former clients of Guildnet who transitioned to another plan after March 20, 2017. This letter instructed the former participants that they must call Medicaid Choice before December 29, 2017, at 1-888-401-6582 to request that their hours be restored to the amount Guildnet had authorized, if the new plan reduced their hours.
The consumer is still eligible to have their previous level of care restored if:
- They were in Guildnet and left after March 20, 2017
- Are still eligible for the Medicaid program, and
- When they enrolled in their current MLTC plan, they were authorized for fewer hours of care and services than they received from Guildnet.
If you or someone you know meet this criterion, be sure to call Medicaid Choice today! If a consumer’s hours are not restored under this procedure, call us at 516-683-1717.
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