Alert for Hawaii Evercare members

Evercare in Hawaii welcomed the new year for some Hawaii families by giving them only four days notice that home nursing services were being cut.

The victims are the families of our state's most vulnerable population: children and adults who would otherwise be locked up in institutions due to their disabilities, whether from birth, age or accident.

According to the evidence I've seen, Evercare dated the letters December 27 (Monday), and families received the letters on December 28 (Tuesday). Service providers also received notice on December 28, including the schedule showing that cuts would begin to go into effect on January 1.

Evercare told the families they could call or write (to Tampa, Florida) to appeal the decision. In at least one case I am aware of, the January 1 service cuts were implemented even though a family had telephoned in their appeal and specifically asked for services to remain in place. (That was one requirement of several imposed by the letter: that if you didn't ask specifically for your existing services to remain in place during your appeal, they wouldn't.)

The Evercare letter stated that existing services would only remain in place if five conditions were met, one of which was the appeal was filed within ten calendar days of the date on the letter (December 27). Unfortunately, that conflicts with the thirty day time period recipients were given to file an appeal,

Families who have not yet filed appeals need to do so as quickly as possible. I would recommend emailing or faxing them to your Evercare service provider if possible, in addition to mailing it to Florida. You need to be able to have a record that the company received your appeal.

If cuts have already gone into effect, you can ask for an expedited appeal on the basis that your loved one's health and safety at home are being endangered.

Once you have your appeal in place, you might want to think about enlisting your doctor's help in getting the services back, or even getting them increased if that is what is medically necessary.

I wrote an article on my other blog about letters of medical necessity and how to file them. Here is Evercare's prior authorization request form that the doctor must fill out, and fax, with the letter, to the fax number on the top.