Stotler Hayes Group, LLC

Stotler Hayes Group, LLC A Law Firm Exclusively for Healthcare Providers. Please view our disclaimer at: https://stotlerhayes.com/disclaimer/

Medicaid | Penalty Periods | Guardianship | Probate | Litigation | Private Payment | Training & Education

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https://stotlerhayes.com/disclaimer/

When a case slows down, it’s not random—and it’s rarely just “processing time.”More often, the file is missing something...
06/05/2026

When a case slows down, it’s not random—and it’s rarely just “processing time.”

More often, the file is missing something the agency needs to move it forward. That could be inconsistent financials, unclear transfers, documentation gaps, or details that don’t fully line up.
And when that happens, the file doesn’t get rejected right away—it gets stuck.

For facilities, that stall matters. It impacts census planning, billing timelines, and how quickly a bed turns over.

But the good news is that stalled cases are usually solvable cases, if the underlying issue is identified and corrected in the file, not just waited out.

If your applications are sitting without movement, it may be time for a file review to identify what’s holding them up!

When a resident is unable to manage their own affairs and has no authorized family member or legal agent available to as...
06/01/2026

When a resident is unable to manage their own affairs and has no authorized family member or legal agent available to assist, securing Medicaid benefits can become a major challenge for long-term care providers.

In some situations, guardianship may be necessary to move the Medicaid application process forward. But what exactly does a guardian do, and what responsibilities come with that role?

Check out this article by SHG Attorney, Chris Holleman, as he provides an overview of guardianship, the duties of a guardian, and how guardianship can help facilitate Medicaid eligibility for incapacitated or incompetent individuals.

https://www.jdsupra.com/legalnews/guardians-fiduciary-duties-7067418/

We recently secured a favorable ruling in a Medicaid appeal where the Virginia Department of Medical Assistance Services...
05/28/2026

We recently secured a favorable ruling in a Medicaid appeal where the Virginia Department of Medical Assistance Services sought to have the case dismissed on standing grounds following the resident’s death.

The Circuit Court disagreed and confirmed that our client has standing to proceed under the Virginia Administrative Process Act, allowing the appeal to move forward to be heard on its merits.

The case involves a 2021 long-term care Medicaid admission, a 2024 renewal termination after the end of the Public Health Emergency, and over $77,000 in Medicaid coverage at issue during the relevant period.

After multiple procedural challenges at the agency level and an initial dismissal on standing, the Court’s ruling ensures the underlying issues can now be fully reviewed.

We will continue advancing the case through the appeals process, with key due process and regulatory issues preserved for further consideration.

This Memorial Day, we recognize and honor those who have served our country and the sacrifices made in service to others...
05/25/2026

This Memorial Day, we recognize and honor those who have served our country and the sacrifices made in service to others. We are grateful for their commitment and dedication.

Wishing everyone a safe and meaningful Memorial Day!

A client recently came to us with a MassHealth transfer issue involving a resident who had transferred her home to her s...
05/22/2026

A client recently came to us with a MassHealth transfer issue involving a resident who had transferred her home to her son for $1, resulting in a substantial penalty and potential loss of coverage.

Rather than moving immediately to litigation, we resolved the matter directly with MassHealth through a focused, well-supported submission and strategic documentation.

What this means for billing and facility teams: in many cases, the outcome turns less on the underlying facts and more on how clearly and effectively those facts are presented—and when they are addressed.

If a case feels stuck or headed toward a denial, it’s often not the situation—it’s how it’s being presented. We are happy to take a look if you’re dealing with something similar.

When it comes to Medicaid applications, appeals, guardianships, and conservatorships—experience isn’t optional. It’s eve...
05/20/2026

When it comes to Medicaid applications, appeals, guardianships, and conservatorships—experience isn’t optional. It’s everything.

We’ve handled hundreds of cases over decades of practice.

That means we’ve seen what causes delays, what triggers denials, and what actually works when it matters most.

This isn’t guesswork.
It’s strategy built on experience.

If you need it done right the first time, we’re ready to help.

We’re heading to the OHCA Annual Conference this year—and we’re bringing real-world solutions with us.If you work in lon...
05/18/2026

We’re heading to the OHCA Annual Conference this year—and we’re bringing real-world solutions with us.

If you work in long-term care, you already know how fast things can shift: eligibility issues, documentation gaps, stalled Medicaid applications, and cases that don’t move the way they should.

That’s where we come in.

Stop by Booth 736 to talk through the cases that are slowing your team down. These are the issues we resolve every day—and a quick conversation can often reveal what’s actually driving the delay and what needs to happen next.

Please join us in congratulating Jacqueline Venezia on her promotion to Senior Associate. Jacqueline has been practicing...
05/15/2026

Please join us in congratulating Jacqueline Venezia on her promotion to Senior Associate.

Jacqueline has been practicing law since 2019 and is licensed in South Carolina, North Carolina, and Tennessee. Known for her professionalism and approachable demeanor, Jacqueline brings a positive and steady presence to both client and team interactions!

We’re headed to the Arkansas Health Care Association 2026 Spring Convention—and we’re bringing the energy with us!If you...
05/12/2026

We’re headed to the Arkansas Health Care Association 2026 Spring Convention—and we’re bringing the energy with us!

If you’re attending, make sure to swing by our booth!

Whether you’ve got a tough Medicaid case, a question that’s been keeping you up at night, or just want to meet the team behind the wins—we’d love to connect.

Come chat, swap stories, and see how we help providers turn complicated cases into real results.

Any transfer of assets for less than fair market value during the 60 months prior to a Medicaid application is subject t...
05/04/2026

Any transfer of assets for less than fair market value during the 60 months prior to a Medicaid application is subject to review. This includes gifts, property transfers, and even informal financial support to family members.

If identified, these transfers can trigger a penalty period of ineligibility—even if the resident is otherwise clinically and financially eligible.

Facilities that incorporate proactive financial review, clear documentation, and early legal coordination into the admissions process are better positioned to:
- Identify potential transfer issues upfront
- Set realistic expectations with families
- Reduce exposure to denials and retroactive penalties

When it comes to Medicaid eligibility, what happened five years ago can directly impact reimbursement today.

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297 Willbrook Boulevard
Pawleys Island, SC
29585

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+18432359871

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