DHA Case No. FCP 197394 (Wis. Div. of Hearings and Appeals March 9, 2020) (DHS) ↓ Download PDF Benefits cannot be denied for lack of verification unless the member had adequate notice and the ability to produce the required verification. In this case, the petitioner, an incapacitated woman with dementia, moved to a CBRF. The […] Read more
Tag: 4.7 Notices & fair hearings
DHA Case No. 197019 (Wis. Div. of Hearings and Appeals March 17, 2020) (DHS) ↓ Download PDF The Division of Hearings and Appeals must receive notice of a Medicaid appeal within 45 days of the negative decision or the date it went into effect, and DHS must generally receive verification by its due date to […] Read more
DHA Case No. MAP 199545 (Wis. Div. of Hearings and Appeals December 17, 2020) (DHS) ↓ Download PDF Medicaid applicants must have adequate notice of the proof needed to verify their assets. In this case, the agency issued a Notice of Proof Needed after finding additional accounts in the Asset Verification System (AVS), but the […] Read more
DHA Case No. MDV 200210 (Wis. Div. of Hearings and Appeals January 21, 2021) (DHS) ↓ Download PDF An appeal must be filed within 45 days of an agency action for the ALJ to have jurisdiction to review it. In this case, the petitioner established an irrevocable trust, divested, and applied for Medicaid in May […] Read more
DHA Case No. MGE 201671 (Wis. Div. of Hearings and Appeals June 15, 2021) (DHS) ↓ Download PDF A Medicaid member must have adequate notice of any change in his or her patient liability. In this case, the petitioner elected online notices and a notice of patient liability was posted to her ACCESS account. Her […] Read more
DHA Case No. MAC 205887 (Wis. Div. of Hearings and Appeals December 29, 2022) (DHS) ↓ Download PDF A mailed hearing request is considered filed on the date of the postmark or the date DHA actually receives it, whichever is earlier. In this case, the petitioner mailed the request, but there was no postmark and […] Read more