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Judge's ruling temporarily stops changes planned by DHHS

An administrative law judge on Friday stopped changes to how the state Department of Health and Human Services allots care.

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N.C. health, mental health, Medicaid generic
RALEIGH, N.C. — An administrative law judge on Friday stopped changes to how the state Department of Health and Human Services allots care.

The Association for Home and Hospice Care of North Carolina Inc. filed suit against the state asking that changes to how care is determined be stopped.

Judge Don Overby on Friday placed a preliminary injunction on the Division of Medical Assistance from using a new scoring system to determine how many hours of in-home care each of the more than 37,000 current patients can receive.

Overby extended a temporary restraining order because he said it was likely the association would succeed in a hearing scheduled for April 26 on the merits of the case.

Nurses, family members and caregivers told Overby that the review would result in drastic cuts that 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," association CEO Tim Rogers said in the statement released Friday.

DHHS is under pressure to reduce costs because of budget cuts made by the state legislature. The agency admitted that the review of care was spurred by budgetary concerns.

In his ruling, Overby found association members would be harmed if DHHS proceeds with the planned cuts.

But Overby said the division could write letters to 3,030 Medicaid personal care service recipients who don't appear to meet minimum eligibility requirements because the agency's review looks valid.

“We could not be more delighted with the court’s decision in ruling on behalf of 37,000 PCS patients,” Rogers said.

“The court stated emphatically medical necessity is the key to who should receive care."

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