Minimum Federal Requirements for Medicaid Fair Hearings Each State must give Medicaid applicants the right to a fair hearing when applications are denied, improperly approved, or simply not acted in a timely manner. 42 U.S.C. § 1396a(a)(3); 42 C.F.R. §§ 431.200-431.250; 42 C.F.R. § part 438. The State’s hearing system must provide for a hearing […]
All applications for ABD Medicaid require that the applicant’s basic eligibility be verified. See ABD Manual Section 2201-4. Applications for long-term care Medicaid also require verification of income and resources, but caseworkers are instructed to “For ABD Medicaid verification requirements, see the sections pertaining to the specific COA and the Income and Resource Chapters.” ABD […]
If benefits are being terminated or reduced, the applicant/recipient may request that benefits continue while the appeal is pending. A request for continuation of benefits must be made within ten days following issuance of the notice. See 42 C.F.R. § 431.231(c)(2). Allowance should be made in the event the Applicant’s reports late receipt of notification […]
Right to a Hearing The right to a hearing is a property right and belongs to the applicant. See Bd. of Regents v. Roth, 408 U.S. 564 (1972) (“Property interests, of course, are not created by the Constitution. Rather, they are created and their dimensions are defined by existing rules or understandings that stem from […]
Theoretically, Medicaid should be simple. It’s anything but simple. Also, theoretically, the Medicaid program should be administered in the best interests of Medicaid recipients. 42 C.F.R. § 435.902. Anyone who has worked on more than a few Medicaid applications knows otherwise. Still that’s what federal law requires. 42 U.S.C. § 1396a(a)(19) must “provide that State […]
Taking over a case started by someone else is never my preference. It’s far easier to do something correctly the first time. So what do you do when you’re brought in to fix a case. You pray! First, if someone hires you and no decision has been made, review the file. If there is an […]
We regularly post links to news articles and other resources related to Elder Law and Special Needs Law. We focus on general news, health and healthcare news, special needs news, events, government sources, financial and retirement news and legal news. Some cited resources are for professionals, but most are news or other helpful articles we […]
The answer is, yes, maybe. At USA.gov, there are tips for caregiver support including links to programs that could pay you to serve as a family caregiver. That site offers the following insight: A caregiver helps a person with special medical needs in performing daily activities. Tasks include shopping for food and cooking, cleaning the […]
Who can file An application must be provided to anyone upon request and may be requested in person, by mail, telephone, facsimile, secure e-mail, or at any designated agency. ABD Manual 2050-1. Anyone may apply for Medicaid benefits, including the following: The individual requesting assistance; A personal representative (PR) acting on behalf of the applicant. […]
The Department must dispose of each application by a finding of eligibility or ineligibility, unless: (1) there is an entry in the case record that the applicant voluntarily withdrew the application, and that the Department sent a notice confirming his decision; (2) there is a supporting entry in the case record that the applicant has […]
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