Medicaid (ALTCS) Fair Hearings & Appeals
Phoenix ALTCS Appeal Lawyers
The Arizona Long Term Care System (ALTCS) is a branch of the state’s Medicaid program and is intended to provide support for people in need of long-term care, including seniors and disabled adults. Eligibility is based on an assessment of the applicant’s financial situation and medical needs, using a system that requires 60 points or more for an application to pass.
Unfortunately, the majority (about 70%) of ALTCS applications are denied. Why?
- The applicant failed to meet medical requirements.
- The applicant’s income exceeded ALTCS limits.
- The applicant’s resources exceeded ALTCS limits.
- The applicant failed to file or respond to ALTCS in a timely manner.
- The applicant recently transferred property or assets.
- The applicant owns a home that’s held in a revocable trust.
If your application was denied, this is not the end of the road. You can file an appeal. This must be done within 60 days, however, so act quickly and involve a Phoenix ALTCS appeal lawyer who can help you pursue the benefits you need.
When Should I Consider Filing an ALTCS Appeal?
Medicaid and ALTCS appeals are requests for the Arizona Health Care Cost Containment System (AHCCCS) to reconsider or change its decision regarding coverage. Appeals may be filed for an overall denial of coverage or for a specific item or service. Your right to an appeal is important, and at Taylor & Lihn, PLLC we’re here to protect this right.
You may file an ALTCS or Medicaid appeal for any:
- Denial of a service or benefits
- Termination of a service or benefits
- Reduction in benefits
- Suspension of a service or benefits
- Transfer to a different nursing home/facility
The ALTCS/Medicaid Appeals Process
If you want to file a Medicaid or ALTCS appeal, a specific timeline and process will apply. You need to follow this process and meet all deadlines, or your right to an appeal may be jeopardized. With extensive experience with ALTCS appeals, our attorneys can guide you through the process while preserving your rights and interests.
The full ALTCS appeals process goes as follows:
- You file an application with ALTCS.
- Within 14 days, you receive a decision.
- If your application is denied, you’ll receive a written Notice of Action.
- You’ll then have 60 days to file an appeal.
- If ALTCS denies your appeal, you’ll receive a written Notice of Appeal Resolution.
- You’ll then have 30 days to request a Fair Hearing.
- Within 30 days, your Fair Hearing will be held at the Office of Administrative Hearings (OAH).
- Within 20 days, an Administrative Law Judge will issue a Recommended Decision to AHCCCS.
- Within 30 days, an AHCCCS director will review the judge’s decision and issue a Director’s Decision.
Contact Our Medicaid & ALTCS Appeal Lawyers in Phoenix
Many people seek out our help because their applications have been denied or they are simply overwhelmed and tired of dealing with this complex process. At any stage in the Medicaid or ALTCS process, our attorneys are here for you. During an initial consultation, we can talk to you about the status of your claim and how to seek the benefits you need.
To get started, give us a call at (602) 900-9860. We look forward to assisting you.