I'm an in home health aide, have been for 10 years. Recently one of my consumers received a spend down she never had before. I was told through the agency i would not be paid my last two weeks pay bc her spend down hadn't been paid. She can't afford the spend down so I've essentially lost that job. I understand I'm an independent contractor and technically work for the consumer and the agency is a middle man but how can I get paid the two weeks I'm owed that I did work. I hate she has lost her services but losing my income is devastating. Is it even legal to not pay someone that's worked?
"Ask for the Denial in Writing. You should request:
- the exact reason payment was denied,
- the dates involved,
- whether Medicaid rejected the claim,
- and the section of your contract they are relying on.
Sometimes agencies say:
“We can’t pay you” when they actually mean “We don’t want to absorb the loss. Those are different things.
Spend-Down Problems Often Happen Suddenly. What probably happened:
- the client’s income/assets changed,
- Medicaid reassessed,
- a patient-pay amount/spend-down was imposed,
- the client couldn’t meet it,
- coverage lapsed or retroactively denied.
Sadly, consumers are often just as blindsided as caregivers.
Contact Your State Labor Department. If the agency refuses payment for already-worked hours, contact:
- your state labor board,
- wage-and-hour division,
- or an employment attorney/legal aid clinic.
Use phrases like:
“nonpayment of earned wages,”
“misclassified independent contractor,”
“home health aide wage dispute.”
Many states take unpaid wage claims seriously.
Also Check Whether the Spend-Down Was Applied Retroactively. Sometimes:
- a paperwork error,
- missing receipts,
- or delayed Medicaid processing
creates a temporary denial that later gets fixed.
If the client appeals or satisfies the spend-down later, the agency may eventually get paid."