A Guardianship proceeding was commenced by the skilled nursing facility on behalf of a resident. Medicaid failed to provide benefits under “conditional approval” or “provisional benefits” upon the commencement of the Guardianship proceeding as required by statute. The facility’s attorneys failed to take adequate action to secure Medicaid benefits. More than a year later, after the Guardian was commissioned and it became apparent that the Guardian would not fully cooperate with the processing of the Resident’s Medicaid application, a motion to remove the Guardian was filed. While the filing of the motion to remove the Guardian should have once again resulted in the issuance of a conditional approval or provisional Medicaid benefits, the Medicaid Program once again failed to authorize coverage. The facility’s counsel again failed to adequately address and correct this error. Within 3 months of the substitution of Cona Elder Law as counsel for the skilled nursing facility, utilizing its superior knowledge of the law and unwavering persistence and without even attending a Fair Hearing, the Medicaid Program granted provisional coverage retroactive 24 months and recertified the next 12 months, thereby securing continuity of payment on this Resident’s account.
$255,000 secured in retroactive Medicaid Benefits as well as on-going coverage
Cona Elder Law Attorney
This case was successfully handled by Diana Choy-Shan, Esq.