Medicaid Appeals

We help nursing home residents in Georgetown, TX and San Antonio, TX appeal wrongful denials for long-term care Medicaid.

Medicaid can be denied for many reasons. However, you may have options you were not even aware of. Elder Law Attorneys have filed Medicaid applications and have experience with Medicaid Appeals. Seniors in need of nursing care will ask about whether they should apply for Medicaid. The answer depends on their income level, the value of their assets, and whether they or their spouse is a military veteran. Medicaid is only necessary when an individual has exhausted private long-term care insurance benefits and wants to preserve a legacy for their friends and family.

Marquardt Law Firm, P.C. represents Medicaid applicants in Medicaid appeals. Medicaid applicants are entitled to an appeal process under Federal United States regulations, 42 CFR §431.205, and Texas State regulations under 1 Texas Administrative Code (TAC) §357.3(a)(1). The first step in the Medicaid appeals process is the fair hearing. The first fair hearing is held by telephone conference. The medicaid applicant, the medicaid eligibility worker, and the hearing officer are invited to participate.

You are allowed represent yourself, you are allowed to nominate a personal representative to speak on your behalf, and you are allowed to hire an attorney. It is a crime, however, under §12.001 of the Texas Human Resources Code for a person who is not licensed to practice law in Texas to charge a fee for representing an applicant or recipient or preparing a Medicaid application.