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Medicaid Appeals

Medicaid Eligibility Determinations
After an application is submitted, the local Medicaid agency will eventually make an eligibility determination, and the application either will be approved or denied. If an application is denied, the applicant has a right to appeal and request a fair hearing. Denials are often made in error and an appeal is necessary to correct the error.

All Medicaid programs are required to issue the applicant a written denial, explaining the basis for the determination and procedures to appeal. Failure of the denial notice to explain the denial or give adequate instructions to the beneficiary on how to appeal can void the denial of services. If the applicant appeals the denial on a timely basis, the State must grant the applicant an administrative hearing, called a Fair Hearing.

Medicaid Appeal Hearings
Medicaid Fair Hearings are very informal. General court rules of procedure and rules of evidence are followed.  The hearing officer permits both sides to enter all relevant evidence into the record. The ruling of the hearing officer is limited to whether or not Medicaid complied with federal and state rules and regulations in denying eligibility.

Medicaid Appeals Assistance
Attorneys at the Law Offices of Mary Markovich, PA handle Medicaid Eligibility appeals to assist clients who have been denied Medicaid or other public benefits.

The Law Offices of Mary Markovich, PA assists clients with Medicaid Eligibility Appeals.