Medicaid Appeals and Fair Hearings: Challenging Eligibility Denials, Transfer Penalties, and Benefit Reductions

This CLE webinar will discuss how to challenge Medicaid eligibility denials, transfer penalties, resource and income determinations, benefit reductions, agency delays, and other unfavorable Medicaid determinations. The panel will discuss how to analyze the agency's decision and identify grounds for appeal, develop the record, prepare and present the fair hearing case, and preserve issues for further review.

Medicaid eligibility decisions often involve complex details about asset transfers, resources and income, trusts, annuities, and required documentation. Counsel must understand the basis for the decision and determine how best to challenge it, whether the determination resulted in an application denial, a transfer penalty, benefit reduction, or another agency result.  

After an adverse decision, it becomes critical to review all hearing rights and deadlines, obtain and analyze the agency file, identify controlling law and regulatory standards, and marshal evidence to support the client. Counsel must also determine whether it is possible to continue benefits, expedite reconsideration, or reach a different resolution before the hearing. Finally, counsel must prepare and present the case at the proceeding and preserve any issues for further review. 

Listen as our authoritative panel examines strategies for challenging adverse Medicaid determinations, preparing and presenting fair hearing cases, building an effective record, and preserving issues as needed for further review.