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The Administrative Law Section of The Florida Bar and

Florida Legal Services, Inc. Present

Representing Clients Who Challenge Medicaid Waiver Determinations

By the Agency for Persons with Disabilities (APD)

 

For Complete Details and to Sign Up for the Project, visit

www.floridaprobono.org

 

Originally Held November 14, 2008.  Now available on-demand below.

 


Medicaid Waiver Determinations by the APD 1 of 4 from Florida Legal Services, Inc. on Vimeo.
Welcome and Introduction; then:
Overview of Medicaid and Medicaid Waiver Programs
A.Medicaid State Plan Services
1.Services for Adults
2.Children and EPSDT
B.Medicaid Waiver Program purpose & legal framework
1.Federal Medicaid waiver law
2.Applicable state law
C.Waiver Eligibility Determinations
Chapter 393 eligibility
Medicaid eligibility
Waiting lists
D.Agencies’ responsibilities
1.AHCA (Medicaid and other waivers)
2.DCF (eligibility and other waivers)
3.APD (DD Waiver)


Medicaid Waiver Determinations by the APD 2 of 4 from Florida Legal Services, Inc. on Vimeo.

 APD Assessment and Service Planning Process
A.Support coordination and role of waiver support coordinator
B.Assessment process
C.Key documents (e.g., ICG, support plan, cost plan)
D.Service continuum and service definitions
E.Medical Necessity


Medicaid Waiver Determinations by the APD 3 of 4 from Florida Legal Services, Inc. on Vimeo.

 Florida Developmental Disabilities Waiver Program
A.Tier system enactment and implementation
1. Description and limitations of services under the four tiers
2.Assignment of tiers
3.Effect of tier system on existing adult waiver recipients
4.Effect of tier system on children waiver recipients
5.Special considerations of the Consumer Directed Care (CDC+) Program
6.Current Disputed Issues, Legal Strategies and Negotiation


Medicaid Waiver Determinations by the APD - 4 of 4 from Florida Legal Services, Inc. on Vimeo.

 Due process rights
A.Federal Medicaid due process rights
1.Notice requirements
2.Right to continued services pending a hearing
3.Right to a hearing
B.DOAH jurisdiction for APD hearings
C.Fair hearings for eligibility and other waivers
D.Guardian advocates
E.Sample pleadings/Orders

 

Click here to download the materials

(including powerpoints used & documents referenced above)

 

For Legal Services Attorneys or Pro Bono Volunteers working on this project,

email Kathy Grunewald, Statewide Director of Training, for CLE information.

 

Click here for the 2nd Training in this 2-training series.

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