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Medicaid Appeals and Fair Hearings


By: René H. Reixach, Esq. Woods Oviatt Gilman, LLP


By: René H. Reixach, Esq. Woods Oviatt Gilman, LLP

There are a variety of reasons a Medicaid application may be denied including improper funding and incomplete documentation. The Medicaid rules allow applicants the right to a fair hearing in front of the state agency for adverse determination including denial, reduction, or termination in coverage. This session will cover the rules for fair hearings to review adverse Medicaid eligibility decisions and the procedures for conducting fair hearings, as well as how to appeal to state or federal court from an adverse fair hearing decision.

  • The Basis for Fair Hearings
  • Notice Requirements – Contents and Timing
  • Requesting a Fair Hearing
  • Aid Continuing (Aid Paid Pending)
  • Denial or Dismissal
  • Hearing Procedure
  • Decisions
  • Compliance
  • Hearing Tips
  • Appeals to State Court
  • Federal Court Appeals

 CLE: 1.25 hours

This course has been pre-approved in: AR (1.25), CA (1.25), FL (1), GA (1.3), IN (1.3), IL (1.25), KY (1.25), MO (1.8), NC (1.25), NJ (1.25), NY (1.25), OH (1.25), PA (1), TX (1.25), VA (1). Due to pre-recorded programming rules, this program will not be accredited in: CO, DE, KS, SC. Attorney will self apply in states not listed.

Many states have strict restrictions on pre-recorded (also called on-demand or distance learning) courses. Please review your State Bar’s rules and ElderCounsel’s CLE guide by state to determine if you are eligible to receive CLE for this course beforeviewing.

Receive CLE packet and attendance certificate: Near the end of the webinar, a button labeled “Receive CLE Packet” will appear in the top right corner of the video. You will be required to enter the attendance code given verbally during the webinar to download the packet. You will not be able to download the packet until you watch the webinar in its entirety. To ensure we are CLE compliant, the packet will not be distributed via email or any other method, it must be downloaded following the instructions above.


How long is this course?
Uninterrupted, the video portions of this course should last approximately 3 hours 18 minutes, but we’d suggest to allow for taking notes and of course, the quizzes. So all told, allow for around 4 hours.

When can I take this course?
Once you select to take this course, it will be available to you 24/7. There is no expiration date or time limit for completion, so study at your own pace.

Are there any course materials?
There are no downloadable materials for this course.

How much is this course?
Medicaid Appeals and Fair Hearings retails for $95 but is FREE for ElderCounsel Members!

Will my progress be saved if I have to leave?
Yes! Any progress you make on this course will be saved so you can pick up where you left off.