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Georgia State Medicaid Plan - Rules of Evidence - Scholarly Articles - Medicaid's Obligation to Respond to a Medicaid Application - Appeal Challenging

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 […]

Georgia State Medicaid Plan - Rules of Evidence - Scholarly Articles - Medicaid's Obligation to Respond to a Medicaid Application - Appeal Challenging

Applicants seeking Medicaid must file a signed application with the Department. At this time, the application can be submitted through the Georgia Medicaid Gateway, through a portal at the nursing home, by visiting a local DFCS office, or through a centralized number. The initial phase of process is complete when an eligibility determination notice is […]

Georgia State Medicaid Plan - Rules of Evidence - Scholarly Articles - Medicaid's Obligation to Respond to a Medicaid Application - Appeal Challenging

Carol and Wilbur Post are typical Elder Law clients. Carol married Wilbur more than forty years ago. Recently, Wilburโ€™s health declined. Wilbur has dementia and is living on Planet Alzheimerโ€™s. Wilbur hears voices, especially when he wanders near the Postโ€™s barn. Wilbur needs assistance with activities of daily living. Carol recently admitted Wilbur to Valley […]

Georgia State Medicaid Plan - Rules of Evidence - Scholarly Articles - Medicaid's Obligation to Respond to a Medicaid Application - Appeal Challenging

Both O.C.G.A. ยง 49-4-153(b)(1) and 42 C.F.R. ยง 431.244(g) require that all Medicaid agency decisions be accessible to the public, except that 42 CFR ยง 431.305(b) requires that the following information must be safeguarded: (1) Names and addresses; (2) Medical services provided; (3) Social and economic conditions or circumstances; (4) Agency evaluation of personal information; […]

Georgia State Medicaid Plan - Rules of Evidence - Scholarly Articles - Medicaid's Obligation to Respond to a Medicaid Application - Appeal Challenging

Right to Hearing, Generally Medicaid applicants and beneficiaries are entitled to adequate notice of state agency actions and a meaningful opportunity for a hearing to review those decisions whenever their claim for benefits is denied or not acted upon with reasonable promptness. Federal law, at 42 U.S.C. ยง 1396a(3); 42 C.F.R. Part 431, Subpart E, […]

Georgia State Medicaid Plan - Rules of Evidence - Scholarly Articles - Medicaid's Obligation to Respond to a Medicaid Application - Appeal Challenging

A single state agency must be designated to administer or supervise the administration of the State Plan. 42 U.S.C. ยง 1396a(a)(5); 42 C.F.R. ยง 431.10(b)(1). Specifically, 42 U.S.C. ยง 1396a(a)(5) provides: A State plan for medical assistance mustโ€” either provide for the establishment or designation of a single State agency to administer or to supervise […]

Georgia State Medicaid Plan - Rules of Evidence - Scholarly Articles - Medicaid's Obligation to Respond to a Medicaid Application - Appeal Challenging

Medicaid is a cooperative venture of the state and federal governments. If a state chooses to participate in the Medicaid program, it submits a state plan for the funding of medical services for the needy. The State plan must be approved by the Centers for Medicare and Medicaid Services (CMS). The federal government then subsidizes […]

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 […]

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 […]

Georgia State Medicaid Plan - Rules of Evidence - Scholarly Articles - Medicaid's Obligation to Respond to a Medicaid Application - Appeal Challenging

There are times when formal “legal” communication is necessary. This post addresses several instances regarding how that can be done. It is not meant to be all inclusive and, in many cases, specific communication rules apply. Beginning a lawsuit: When you begin a lawsuit, a summons must be served on the Defendant(s). Generally, Rule 4 […]

Gibbs and Ali

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 […]

Gibbs

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 […]

Bibbs and Ali

During COVID-19, the Centers for Medicare and Medicaid Services (“CMS”) prohibited most state Medicaid agencies from disenrolling individuals who received Medicaid. However, the rules installed to protect Medicaid recipients during the pandemic are currently scheduled to end in October, 2022, and, as pointed out in an NPR special, many families are expected to face hardship. […]

Gibbs

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 […]

Elle

Medicaid’s estate recovery claim is essentially a creditor’s claim allowing the State to recover medical assistance paid on behalf of recipients of long-term care Medicaid. Authority for the claim is found atย 42 U.S.C. ยง 1396p(b). The claim is limited to the applicant’s estate, although State laws vary regarding what the estate looks like. As shown […]

Elle

We regularly post links to news articles and other resources that 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 […]

Georgia State Medicaid Plan - Rules of Evidence - Scholarly Articles - Medicaid's Obligation to Respond to a Medicaid Application - Appeal Challenging

Let’s assume Betty, a widow, will go to a Georgia nursing home in the near future (using 2022 eligibility rules and limits) and has the following resources: A home A retirement account A CD designated for burial in the amount of $14,000 One vehicle Savings of $15,000 Checking of $1,600 In addition to her resources, […]

Gibbs and Ali

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 […]

Elle

*** Note: This issue is abbreviated due to the July 4th Holiday *** 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 […]

Gibbs

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 […]

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 […]

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 […]

Elle

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 […]

estate planning

In Gallardo v. Marstiller (U.S. June 6, 2022 (Google Scholar link)), the U.S. Supreme Court held that a State may seek reimbursement of future medical expenses from injury settlement funds. Prior to Gallardo, the primary cases governing the extent of a State’s right to seek reimbursement for medical assistance (Medicaid) were Arkansas Dep’t of Health […]

Gibbs, Ali and Elle

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 […]

Georgia State Medicaid Plan - Rules of Evidence - Scholarly Articles - Medicaid's Obligation to Respond to a Medicaid Application - Appeal Challenging

Several overriding rules control the creation and application of Medicaid eligibility criteria by the states. These rules are applicable to all mandatory and optional coverage groups, as well as all medically needy individuals.ย  First, a state may not impose any eligibility requirements prohibited by Title XIX. Next, the state must base coverage or optional coverage […]

Elle

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 […]

Georgia State Medicaid Plan - Rules of Evidence - Scholarly Articles - Medicaid's Obligation to Respond to a Medicaid Application - Appeal Challenging

The following are the Covid 19 Medicaid Waivers we’re aware of. If you have information on others, please let us know at websupport@ezelderlaw.com. Policy Round Up: COVID-19 updates, opioid use disorders and the ADA, hospital and nursing home ownership, input opportunities CMS: Coronavirus waivers & flexibilities CMS: Internal Medicaid and Chip Covid 19 Summary CMS […]

Ali

We regularly post links to news articles and other resources that 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 […]

Georgia State Medicaid Plan - Rules of Evidence - Scholarly Articles - Medicaid's Obligation to Respond to a Medicaid Application - Appeal Challenging

In a recent case (Dep’t of Tenncare 4/20/2022), Appellant’s application for nursing home Medicaid was denied due to ownership of a life insurance policy with a cash value of $2,184.66. She had been under a limited conservatorship since June 2, 2021. The Medicaid application was filed on July 21, 2021. Neither Appellant nor the limited […]

Major

We regularly post links to news articles and other resources that might be of interest to our viewers. We focus on general news, health and healthcare news, special needs news, events, government sources, financial and retirement news and legal news. Only headlines are listed so you can use this page like a newspaper, reading only […]

Georgia State Medicaid Plan - Rules of Evidence - Scholarly Articles - Medicaid's Obligation to Respond to a Medicaid Application - Appeal Challenging

In 2020, the DC Circuit Court of Appeals decided Gresham v. Azar, 950 F.3d 93 (2020). There, the Court of Appeals affirmed a District Court decision halting Arkansas Works, a program that imposed work requirements on impoverished adults seeking Medicaid under the ACA expansion. Arkansas Works included new requirements in addition to the much-discussed work […]

Gibbs and Ali

We regularly post links to news articles and other resources that might be of interest to our viewers. We focus on general news, health and healthcare news, special needs news, events, government sources, financial and retirement news and legal news. Only headlines are listed so you can use this page like a newspaper, reading only […]

Georgia State Medicaid Plan - Rules of Evidence - Scholarly Articles - Medicaid's Obligation to Respond to a Medicaid Application - Appeal Challenging

In Weeks v. DHS, Division of Family and Children Services, Office of State Administrative Hearings, Docket 2117014 (April 28, 2021), Brian Center Health and Rehabilitation – Canton, purportedly filed a direct appeal on behalf of Marilu Weeks after her Medicaid application was denied. Judge Teate, in Docket No. 2115533, directed Brian Center to provide evidence […]

Elle

We regularly post links to news articles and other resources that might be of interest to our viewers. We focus on general news, health and healthcare news, special needs news, events, government sources, financial and retirement news and legal news. Only headlines are listed so you can use this page like a newspaper, reading only […]

Gibbs

We regularly post links to news articles and other resources that might be of interest to our viewers. We focus on general news, health and healthcare news, special needs news, events, government sources, financial and retirement news and legal news. Only headlines are listed so you can use this page like a newspaper, reading only […]

Elle

March is Developmental Disability Awareness Month. March is also National Kidney Month. We regularly post links to news articles and other resources that might be of interest to our viewers. We focus on general news, health and healthcare news, special needs news, events, government sources, financial and retirement news and legal news. Only headlines are […]

Georgia State Medicaid Plan - Rules of Evidence - Scholarly Articles - Medicaid's Obligation to Respond to a Medicaid Application - Appeal Challenging

In Cavanaugh v. Geballe (2nd. Cir. 3/17/2022), Cavanaugh, a Connecticut resident, was covered by an Affordable Care Act insurance policy. When his grandmother’s Will was administered, the Department asked the probate court to honor their lien on grandmother’s estate. The probate court held a hearing, after which it determined that fifty percent of Cavanaugh’s distributive […]

Elle

March is Developmental Disability Awareness Month. March is also National Kidney Month. We regularly post links to news articles and other resources that might be of interest to our viewers. We focus on general news, health and healthcare news, special needs news, events, government sources, financial and retirement news and legal news. Only headlines are […]

Mase

In Department of Human Services v. Hobart, the Oregon Court of Appeals ruled, on March 2, 2022, that Oregon’s Medicaid agency could pull a Medicaid recipient’s interest in a marital home back into her estate for purposes of estate recovery. The federal Medicaid law requires States to pursue estate recovery, but some States are more […]

Gibbs

We regularly post links to news articles and other resources that might be of interest to our viewers. We focus on general news, health and healthcare news, special needs news, events, government sources, financial and retirement news and legal news. Only headlines are listed so you can use this page like a newspaper, reading only […]

Georgia State Medicaid Plan - Rules of Evidence - Scholarly Articles - Medicaid's Obligation to Respond to a Medicaid Application - Appeal Challenging

In Geyen v. Commissioner of Minnesota Department of Human Services, 964 N.W.2d 639 (2021), Dorothy Geyen’s application for Medicaid was denied. In 2011, Geyen established two substantially identical irrevocable trusts. Each trust provided that the trustee could not make loans to Geyen and could not make gifts to her. Nonetheless, the Department took the position […]

Georgia State Medicaid Plan - Rules of Evidence - Scholarly Articles - Medicaid's Obligation to Respond to a Medicaid Application - Appeal Challenging

In American National Life Insurance Company v. Breslouf (Mass. Super. 6/3/2021), a Community Spouse named Julius Breslouf purchased a Medicaid annuity as part of the plan to secure Medicaid eligibility for his wife. The annuity named the Commonwealth of Massachusetts as the remainder beneficiary, followed by his daughter, Jennifer Brouslouf. Mr. Breslouf died before the […]

Ali

February is American Heart Month! Read President Biden’s Proclamation on American Healrth Month 2022 We regularly post links to news articles and other resources we believe might be of interest to our viewers. We focus on general news, health and healthcare news, special needs news, events, government sources, financial and retirement news and legal news. […]

Georgia State Medicaid Plan - Rules of Evidence - Scholarly Articles - Medicaid's Obligation to Respond to a Medicaid Application - Appeal Challenging

The Georgia Department of Community Health recently announced the 2022 Presumptive Eligibility Medical Assistance Federal Poverty Levels. These new income limits should be used for all PE determinations completed by Qualified Hospitals effective March 1, 2022. Both memos are below:

Mason

February 18th is National Caregiver’s Day! General News Sources: Will Social Security run out of money? Here’s what could happen to your benefits if Congress doesn’t act Georgia AG Carr Warns Georgians to Beware of Romance Scams | FBI Warning North Macedonia President Walks Girl With Downโ€™s Syndrome To School After She Was Bullied What […]

Elle

General News Sources: Getting the Most from Social Security (NYT – subscription required) The average retiree spends 30% of their Social Security income on health care Governor Mills of Maine) Releases Historic Elder Justice Roadmap Alzheimer’s Foundation of America offers free virtual memory screenings How car sensors monitor Alzheimer’s disease A document checklist for family […]

In Moore v. Noogle, (N.D. GA Case No. 1:19-CV-3296-TWT, 1/24/2022), the Court heard from James Moore and John Panuska, both of whom were injured in seperate motor vehicle collisions. Each had a special needs trust and each applied for newly approved, but not yet implemented, “skilled nursing hourly” benefit under Georgia Medicaid’s ICWP waiver. Delays […]

Georgia State Medicaid Plan - Rules of Evidence - Scholarly Articles - Medicaid's Obligation to Respond to a Medicaid Application - Appeal Challenging

NOTE: If you have a Georgia corporation or limited liability company, your annual return is due by April 1, 2022. General News Sources: Dog Aging Project is looking for more participants National Black (African American) History Month: February 2022 (Census) Tricare coverage and Medicare explained Growing elder populations require more services, awareness NAIC Comments on […]

Aged, blind, or disabled individual means an individual whoโ€” (A) is 65 years of age or older, is blind (as determined under paragraph (2)), or is disabled (as determined under paragraph (3)), and (B) (i) is a resident of the United States, and is either (I) a citizen or (II) an alien lawfully admitted for […]

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