4.6 Representatives

DHA Case No. FCP 210973 (Wis. Div. of Hearings and Appeals January 16, 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’s authorized representative failed to complete his renewal: she “apparently left employment with her payee company, […] 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

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