Administrative Law

State May Recoup Medicaid Benefits Incorrectly Paid

In PR v. Division of Medical Assistance and Health Services (NJ. App. Div. 6/8/2023), the State was authorized to recover…

11 months ago

Administrative decisions and collateral estoppel

The collateral estoppel (issue preclusion) rule is part of the finality doctrine along with Res Judicata (claim preclusion). It general…

11 months ago

Nursing Home Quality of Care Regulations Amended to Remove Expired COVID-19 Provisions

On June 5, 2023, the Centers for Medicare and Medicaid Services (CMS) amended 42 C.F.R. § 483.80 (infection control) and…

11 months ago

Standing in Medicaid and Other Cases

"In general, in order to maintain an action, a party “must establish standing to sue on the ground asserted, which…

12 months ago

No Right to Fair Hearing Unless You Complain About Something

In L.U. v. Division of Medical Assistance (N.J. Superior Court Docket A-2937-20, May 23, 2023), the Superior Court affirmed denial…

12 months ago

Selected Georgia Medicaid Decisions

The following Georgia Medicaid cases were litigated outside the context of an administrative hearing, or were appealed beyond that point.…

12 months ago

Pre-Hearing Conferences in Medicaid Cases

An ALJ may order a prehearing conference to simplify the issues being presented. Conferences may be held in person or…

2 years ago

Verification for Medicaid Applications

All applications for ABD Medicaid require that the applicant's basic eligibility be verified. See ABD Manual Section 2201-4. Applications for…

2 years ago

Requesting a Medicaid Fair Hearing

Right to a Hearing The right to a hearing is a property right and belongs to the applicant. See Bd.…

2 years ago

Correcting the Damage Done Before You Got the Medicaid File

Taking over a case started by someone else is never my preference. It's far easier to do something correctly the…

2 years ago