by Letha Sgritta McDowell, CELA
If you are just venturing into an elder law and special needs planning practice, you have already discovered that the area of practice is defined by the clients you serve. Elder law is much more than just “Medicaid Planning” or “Medicaid Asset Protection Planning.” Elder Law and special needs planning attorneys must be familiar with a wide variety of topics, ranging from Medicare, Medicaid and Social Security, to the Americans with Disability Act.
I recently presented on a panel about Medicaid Fair Hearings and Appeals at the American Bar Association’s National Aging and Law Conference. One topic that arose as part of this panel discussion was the seemingly increased importance of these appeals as state budgets become tighter. The Social Security Act specifically requires each state operated Medicaid program to include a procedure by which an applicant may appeal an adverse decision regarding entitlement to Medicaid or Medicaid waiver services. Whether a result of a concerted effort to save funds, or simply a lack of training among eligibility workers or service providers, the amount of Medicaid Fair Hearings and Appeals seems to be increasing. Certainly, those of us in private practice see an increase in the need to appeal agency decisions or actions when compared with the number of appeals we handled even 10 years ago. As attorneys and advocates for the aging population and people with disabilities, we must be prepared to do just that . . . advocate. That means appealing and advocating when our clients are given an improper decision, or when their services are reduced or terminated.
If your practice has focused on traditional asset protection planning, but you have never taken an appeal, or if you are new to the elder law and special needs planning practice, I highly recommend you review the rules regarding Medicaid Fair Hearings and Appeals. Take a look at the materials from my session (they are available through the American Bar Association). Talk to others in your state who appeal. InterActive Legal subscribers can connect with other elder law and estate planning attorneys on the InterActive Legal forums. You will find a wealth of knowledge and a group of attorneys who are happy to share. A good result on an appeal can help all of us in practice, and becoming proficient at Medicaid appeals can help you distinguish yourself from other attorneys and can add revenue to your practice.
Follow this link to purchase the materials from the National Aging and Law Conference and use them as a guide to start you on your path to successful appeals and more clients.