Granato v. Bane

74 F.3d 406 (2d Cir. 1996); No. 94-7173 (2d Cir. Jan. 22, 1996). ; Clearinghouse Number: 51186

Description

Medicaid Recipients Whose Home Care Services Were Automatically Terminated upon Hospitalization Were Entitled to Notice and Continuing Aid Pending Hearing

Abstract

In these consolidated cases, the Second Circuit has held that the termination by New York Department of Social Services (DSS) of Medicaid home care services upon a recipient’s admission to the hospital constitutes an "action" under 42 C.F.R. § 431.201 triggering the recipient’s right to notice, a hearing, and the continuation of home care services pending that hearing. Plaintiff Medicaid recipients challenged the reduction or termination of their home care services upon brief admissions to the hospital. In Granato the district court found that the termination of plaintiff’s home care upon hospitalization was not an "action" under section 431.201 because plaintiff suffered no detrimental change in health care by being hospitalized. The court also held that DSS’s letter notifying plaintiff that her benefits had been discontinued did not constitute an "action" because plaintiff’s request for a resumption of benefits following hospitalization was technically a new application for benefits, which DSS simply denied. Relying heavily on Granato, the district court in McCoy granted DSS summary judgment, and the cases were consolidated on appeal. Reversing, the court of appeals held that DSS’s decision to treat the discontinuance of services during a hospitalization as an "automatic" termination (as opposed to a suspension) of those services constituted agency action as defined in the regulations. Although home care services were unavailable during the period of hospitalization, DSS was required to notify the recipient in a timely and adequate manner of the termination. It was also required to provide continuing aid pending a hearing so long as the recipient requested a hearing within 10 days of the notice.

Additional Information

Attorney Information
Plaintiff-Appellant represented by Ellen Yacknin, Greater Upstate Law Project, 80 St. Paul St., Suite 660, Rochester, NY 14604, (716) 454-6500; Valerie Bogart, Jonathan Weiss, James Murphy.
Docket Date
1970-01-01 06:00:00+00:00