People who are denied Medicaid or have their benefits terminated are frequently left confused and uncertain about how to proceed. Fortunately, there are some measures that a person in this situation can take to preserve his or her rights. This article will review some of the important steps that a person should take after being denied Medicaid.
Request an Administrative Hearing
A person who receives Medicaid should make sure to request an administrative hearing within 45 days after being denied Medicaid or having Medicaid terminated. To request an administrative hearing, a person must complete an administrative hearing request form (MSC 0443) and submit the document to to the Department of Human Services.
Continue Receiving Benefits
Request forms allow a person to keep the same Medicaid benefits while waiting for a hearing. This can be done by selecting this option on the hearing request form. It is important to note that a person must request to continue receiving benefits within 10 days of Medicaid being terminated. Many people benefit from this decision because the rate of Medicaid reimbursement is frequently less than the private pay rate.
Prepare for the Hearing
Before a Medicaid hearing, states are required to review applications and all submitted information that is relied on to make an approval decision. A person is advised to do the same. It can be helpful to review all of the points that a person wants to make during a hearing so that a person does not forget these facts during the hearing.
Prior to an administrative hearing, a phone call will be conducted with a representative in an effort to resolve this issue. Hearings are conducted by the Office of Administrative Hearings, which involve a judge who will hear the case. These hearings are conducted either by phone or in person. Fortunately, a person can have an attorney represent him or her during these hearings. During the hearing, a person can explain why he or she disagrees with the decision and have any relevant witnesses testify.
Learn What to Expect After the Hearing
After a Medicaid hearing, a person will receive written notice about the applicable hearing officer’s decision. If a person loses the hearing, a notice will inform him or her how to appeal. Some appeals might limit a person to making written arguments about evidence that arose since the first trial.
Request a Reassessment
If you receive a notice of planned action terminating Medicaid benefits because you no longer qualify, it is almost always a wise idea to request a reassessment by another staff member.
Obtain the Services of a Skilled Estate Planning Attorney
If you have been denied Medicaid or your Medicaid benefits have been terminated, speak with a seasoned estate planning attorney like Jim A Lyon. Contact attorney Lyon today to schedule an initial free consultation to determine the best path forward after being denied Medicaid.