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Advice from Medicaid Caseworkers

We reached out to Medicaid caseworkers to see whether they had any advice for law firms helping Medicaid applicants. Not surprisingly, they did have some advice, so here it is:

  • Be honest and don’t hide the ball. It only takes one act of dishonesty to lose trust.
  • File “complete” applications. If they are completed from Gateway, the system gives you an instant confirmation number allowing you to upload documents immediately. Many caseworkers will review the file before the telephone interview so if your documents are already uploaded, you’re ahead of the game.
  • Review documents before sending them to DFCS. Be prepared to answer regarding anything questionable (e.g., sale proceeds, large monies being moved around). Even if everything is Kosher, Medicaid has the right (and obligation) to ask questions.
  • All required forms need to be signed.
  • Supply all pages of numbered statements for each account. Even if a bank statement page is blank, supply it. Caseworkers can’t know a blank numbered page is irrelevant unless you provide it.
  • Provide a direct number for the telephone interview unless someone is in the office to direct the call.
  • Be concise. It’s ok to provide a short cover page or outline, but don’t send long, detailed legal arguments to caseworkers.
  • Make sure the DMA59 is completed correctly with hospital dates. Remember, the hospital dates count toward your LOS requirement.

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