Medicaid

Medicaid Appeals to Superior CourtMedicaid Appeals to Superior Court

Medicaid Appeals to Superior Court

After exhausting all administrative remedies, the Applicant may file a Petition for Review in Superior Court. See O.C.G.A. § 49-4-153(c);…

3 years ago
Medicaid Appeals to the AgencyMedicaid Appeals to the Agency

Medicaid Appeals to the Agency

After entry of an initial decision, the Clerk must certify the record, including the Initial Decision and any tapes or…

3 years ago
Standards Used in Determining EligibilityStandards Used in Determining Eligibility

Standards Used in Determining Eligibility

Medicaid eligibility determinations must be based on “ascertainable standards.” See J. Perkins, Issue brief: Appeal Rights and Medicaid Benefits citing…

3 years ago
The Record in Medicaid CasesThe Record in Medicaid Cases

The Record in Medicaid Cases

A record must be kept in all contested cases. 42 C.F.R. § 431.244 provides: (b) The record must consist only…

3 years ago
Advice from the Bench in Medicaid CasesAdvice from the Bench in Medicaid Cases

Advice from the Bench in Medicaid Cases

In preparing the original version of these materials several years ago, I spoke with one of the Administrative Law Judges…

3 years ago
Evidence in Medicaid HearingsEvidence in Medicaid Hearings

Evidence in Medicaid Hearings

Same rules as non-jury civil cases The rules of evidence applicable in civil nonjury trials apply in administrative hearings. O.C.G.A.…

3 years ago

Hearing Rights and Responsibilities in Medicaid Cases

The Applicant and DFCS have the right to the following: 1. Bring and/or subpoena witnesses; 2. Establish all pertinent facts…

3 years ago
Issues for HearingIssues for Hearing

Issues for Hearing

The fair hearing or the appeal from agency review must give the applicant a de novo hearing if requested. 42…

3 years ago
Discovery in Medicaid CasesDiscovery in Medicaid Cases

Discovery in Medicaid Cases

As a general rule, discovery is not permitted in any proceeding before an ALJ, except to the extent specifically authorized…

3 years ago
Pre-Trial Motions in Medicaid CasesPre-Trial Motions in Medicaid Cases

Pre-Trial Motions in Medicaid Cases

Form All requests made to the Administrative Law Judge shall be made by motion. Unless made during the hearing, motions…

3 years ago