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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 […]

We regularly scour the internet looking for information relating to elder care, special needs and elder law. Although we review a number of sources collecting information, many of the articles listed here were found using Google Scholar Alerts. If a link you need has gone missing, try pasting the link into the Wayback Machine (Internet […]

There are numerous ways to contact Georgia Medicaid. We will list a few here: Online How to Apply (Georgia.gov) Georgia Gateway Customer Portal How to Apply for Medicaid and CHIP (USA.gov) Once you apply for Medicaid your Medicaid application will be assigned to a Medicaid Eligibility Specialist to complete and make an eligibility determination. You […]

There is no automatic right to appeal from the Superior Court to the Court of Appeals. An application for the right to file an appeal is necessary. If it is granted, then appeals follow the typical appeal process. O.C.G.A. § 5-6-35 provides the rule for discretionary appeals: (a) Appeals in the following cases shall be taken […]

After exhausting all administrative remedies, the Applicant may file a Petition for Review in Superior Court. See O.C.G.A. § 49-4-153(c); O.C.G.A. § 50-13-19. The petition may be filed in the Superior Court of Fulton County or in the superior court of the county of residence of the petitioner. O.C.G.A. § 49-4-153(c). O.C.G.A. § 49-4-153(c) provides: […]

After entry of an initial decision, the Clerk must certify the record, including the Initial Decision and any tapes or other recordings of the hearing, to the the parties upon request. Ga. R. & Regs. § 616-1-2-.33. The Applicant or the Department may appeal. In Georgia, the OSAH decision is an initial decision. O.C.G.A. § […]

The ALJ is a representative of the Department throughout the hearing process. As such, the ALJ makes a written recommendation known as the initial decision. Greene v. Dep’t of Cmty. Health, 293 Ga. App. 201, 203 (2008). The initial decision is reviewable by the Department of Community Health. See O.C.G.A. § 49-4-153(b)(1); Ga. R. & […]

Medicaid eligibility determinations must be based on “ascertainable standards.” See J. Perkins, Issue brief: Appeal Rights and Medicaid Benefits citing Holmes v. New York City Hous. Auth., 398 F.2d 262, 265 (2d Cir. 1968). In Holmes, in the context of housing authority decisions, the Court said “due process requires that selections among applicants be made […]

A record must be kept in all contested cases. 42 C.F.R. § 431.244 provides: (b) The record must consist only of— (1) The transcript or recording of testimony and exhibits, or an official report containing the substance of what happened at the hearing; (2) All papers and requests filed in the proceeding; and (3) The […]

In preparing the original version of these materials several years ago, I spoke with one of the Administrative Law Judges (the Hon. Patrick Woodard) regarding what Judges want advocates to know about hearings. Make copies. Although you may presume your judge knows Medicaid law, don’t presume your judge is a Medicaid expert. Make copies of […]

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