Justice brought home

Early this year, we told you of how we restored home health care to a double amputee who was dependent on in-home care. Months later, insurance companies are still cutting back on home care – but the AIDS Law Project remains vigilant. We’ve since successfully represented two more clients in desperate need of home health care.In March, an insurer reduced an Upper Darby client’s daily in-home care hours from 16 to four. The insurer’s documents, which noted his traumatic brain injury and that he needed cueing for daily living, contained several factual errors. The insurer also did not give the client proper notice of its decision to cut his hours. Once we alerted the insurer to the errors, the notice problems, and evidence of the client’s needs, his 16 daily hours were restored. In August, we represented a legally blind client in West Philadelphia who had been receiving 24/7 in-home care after experiencing blackouts since 2019. After an annual review in December 2020, his insurer cut his overnight hours. Five nights after the reduction, he had a heart attack in the middle of the night. His morning health aide arrived and called for an ambulance. As soon as he was stabilized, he requested a return to 24/7 in-home care but was denied. He tried unsuccessfully to advocate for himself, then called us for help.We filed for a hearing before an administrative law judge, submitted evidence to the insurer’s legal department, and requested a settlement. Just a few weeks after he called us, the insurer restored the man’s 24/7 home health care.