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Medicaid Appeals and Fair Hearings

Webinar Recorded: June 7, 2016
Rene H. Reixach, Esq., Woods Oviatt Gilman, LLP
Duration: 71 minutes

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.

Topics covered:

  1. The Basis for Fair Hearings
  2. Notice Requirements – Contents and Timing
  3. Requesting a Fair Hearing
  4. Aid Continuing (Aid Paid Pending)
  5. Denial or Dismissal
  6. Hearing Procedure
  7. Decisions
  8. Compliance
  9. Hearing Tips
  10. Appeals to State Court
  11. 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 before viewing.

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.

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