DHA Case No. MAP 212440 (Wis. Div. of Hearings and Appeals April 16, 2024) (DHS) ↓ Download PDF Applicants for Medicaid are given at least 20 days from the date of a request to provide verification, and benefits may only be denied if the applicant has the power to produce the verification. In this case, […] Read more
Tag: 1.1.4 Time frames
DHA Case No. MGE 209925 (Wis. Div. of Hearings and Appeals January 12, 2024) (DHS) ↓ Download PDF Family Care enrollment can be backdated if agency error by the ADRC or IM causes unreasonable delay. In this case, the petitioner was eligibile on July 6 but not enrolled until July 21 because the ADRC mistakenly […] Read more
DHA Case No. FCP 209869 (Wis. Div. of Hearings and Appeals January 12, 2024) (DHS) ↓ Download PDF In general, the ADRC has 30 days from the date of request to determine functional eligibility or provide notice of a delay; IM has 30 days from the date of application to determine financial eligibility. In this […] Read more
DHA Case No. MGE 209328 (Wis. Div. of Hearings and Appeals December 5, 2023) (DHS) ↓ Download PDF An application for Institutional MA can be backdated up to three months before the month of application. The MEH provides that an application faxed and received by the agency after business hours counts as filed on the […] Read more
DHA Case No. MGE 197380 (Wis. Div. of Hearings and Appeals March 2, 2020) (DHS) ↓ Download PDF In general, a Medicaid application must be processed within 30 days (plus 10 days if needed to provide verification) and the applicant has the burden of providing the needed verification. This case, however, was “highly unusual” for […] Read more