Medicaid: DFCS directed to determine eligibility where application pending over one year

DFCS directed to determine eligibility where application was pending for over one year. Petitioner filed an application for Medicaid on May 22, 2007. On June 18, 2007, a verification package was given to Petitioner’s daughter. On July 1, 2007, the application was denied for failure to provide verification. On July 25, 2007, Petitioner requested a fair hearing, after which, DFCS agreed to re-open the case. As of July 2008, more than a year after the application was filed, no determination had been made. Allegedly the delay related to failure of DCH to approve a special needs trust and a QIT. The court found there is no exception to the standard of promptness for these determinations. The case was remanded with the ALJ stating DFCS “is directed to determine eligibility and provide notification of the disposition of the application within 20 business days of the decision.

OSAH-Hall-Langston-7-2008.pdf (June 3, 2008).

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