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. § […]
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 […]
Same rules as non-jury civil cases The rules of evidence applicable in civil nonjury trials apply in administrative hearings. O.C.G.A. § 24-1-2(d)(4); Ga. R. & Regs. § 616-1-2-.18(1)(a). Irrelevant, immaterial, or unduly repetitious evidence shall be excluded. When necessary to ascertain facts not reasonably susceptible of proof under such rules, evidence not admissible thereunder may […]
The Applicant and DFCS have the right to the following: 1. Bring and/or subpoena witnesses; 2. Establish all pertinent facts and circumstances; 3. Present arguments without undue interference; 4. Question or refute any testimony or evidence, including the opportunity to question and cross-examine adverse witnesses. 42 C.F.R. § 431.242(b) through (e). DFCS has the responsibility […]
The fair hearing or the appeal from agency review must give the applicant a de novo hearing if requested. 42 C.F.R. § 431.232(c). A de novo hearing means it starts over from the beginning. 42 C.F.R. § 431.201. The hearing includes consideration of the following: 1. Any agency action, including the following: a. Denial or […]
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