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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 Genser 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
This case was successfully handled by Diana Choy-Shan, Esq.
Genser Cona Elder Law is a full service law firm based in Melville, LI. Our firm concentrates in the areas of elder law, estate planning, estate administration and litigation, disability planning and health care facility representation. We are proud to have been recognized for our innovative strategies, creative techniques and unparalleled negotiating skills unendingly driven toward our paramount objective - satisfying the needs of our clients.
$157,300 Recovered from Long Term Care Insurance Policy
$246,000 Recovered from New York State Comptroller via Unclaimed Funds
$120,000 Recovered via a Zero NAMI Budget
$306,000 in Medicaid Benefits Secured via PRUCOL
$156,000 Collected by Facility from Real Property