Medicaid Related Articles « Patti’s Publications
Medicaid Appeal (attorney fees and costs case)
- David v. Goliath: One Client's Fight for Attorney Fees and Costs (background article)
As Advocates for folks dependent on needs-based public benefits, we all experience repeated violations of the basic Constitutional rights of due process. When due process rights are violated within the course of the Medicaid eligibility process, or during the administrative hearing phase, an award of attorney fees and costs against the agency may be appropriate and necessary. An individual that prevails at the administrative level should request attorney fees and costs under the Administrative Procedures Act. If the individual does not prevail at the administrative level, and appeals the decision to the Circuit Court level or higher, the prevailing party should consider state or federal law for relief.The need to enforce the Constitutional protections of due process is necessary in an effort to level the legal battleground for our clients that rely upon public benefits. The system is difficult to navigate and becomes even more of a struggle when the rules are ignored by the administrative agencies. Consider the unlimited legal representation and resources agencies have at their beck and call, versus the limited resources of a beneficiary on needs-based benefits. It is a very real time David v. Goliath situation.* Petitioner's Brief on Appeal
* Appellant's Responsive Brief
* Counter Response to DHS
* Affidavit Regarding Fees
* Respondent's Supplemental Brief Opposing Award of Fees or Costs
* Response to Respondent's Brief Opposing Fees or Costs
* Respondent's Post-Hearing Brief Opposing Award of Fees or Costs
* Order (5-22-09)
* Settlement Check
Medicaid Applications and Appeals
- Applications and the Appeals Process
Medicaid is a cooperative federal-state program under which states receive federal funding to provide health care to low-income individuals. State participation in the Medicaid program is voluntary, but if a State elects to participate it must comply with the requirements of Title XIX and applicable regulations. Generally, an individual (or someone acting on his or her behalf) must fill in a Medicaid application, submit it to the local office, and have it processed and approved. If the application is approved, nothing more need be done. If it is denied, however, the applicant will not receive any assistance until a hearing is requested, and the applicant prevails either at the administrative level or on further appeal. -
Attachment 1: Advocacy tips for Responding to The Deficit Reduction Act of 2005
Attachment 2: Single Points of Entry
Attachment 3: Ask Your Legislator to Vote
Attachment 4: Sample Cover Letter
Attachment 5: Frequently Asked Questions
Attachment 6: OCR Fact Sheet
Attachment 7: Discrimination Complaint
Attachment 8: Complaint and Jury Demand
Medicaid – Other Issues
- Medicaid Outside the Context of Long Term Care, Including Special Needs Trusts
In Michigan, Medicaid is available to aged, blind and disabled individuals. There are also asset and income tests that the individual must pass in order to be eligible. This article includes information on Medicaid Waivers, Medicaid and Interstate Travel, Single Point of Entry, Balance Billing Issues, and Special Needs Trusts.
