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sb2 wins hearing worth 494 days of coverage and $91k in back benefits

sb2 challenged a NY Medicaid agency that had incorrectly denied two applications for a resident.  After presenting multiple written briefs and representing the client over the course of three hearing dates, the administrative law judge ruled in favor of the facility, finding that because the agency had provided defective notice to the authorized representative, sb2’s appeal of the 2012 denial was not in fact late. They also found that the Medicaid agency erred when it failed to grant the applicant an extension to submit an outstanding verification.  

 

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