KY Medicaid Consulting for Lawyers and Law Firms

Do you have a client who is facing challenges with Kentucky Medicaid eligibility? Whether it’s due to technical criteria, income and asset limits, or denied coverage, RCOM Consulting provides expert support to law firms handling complex Medicaid cases.

We assist attorneys preparing for administrative hearings, appeals, and circuit court cases involving KY Medicaid programs. If you're representing a client who was denied eligibility or seeking legal clarity on Medicaid standards, you’ve come to the right place.

I have over 23 years of KY Medicaid experience in many different areas of KY Medicaid:

• Basic and long-term care to KY Medicaid Waiver eligibility

• Public assistance fraud investigations for the Cabinet for Health and Family Services’ Office of Inspector General

• Division of Special Investigations (Audits and Investigations Division) 

• KY Medicaid Policies

• KY Medicaid Regulation Compliance

✅ Eligibility & Enrollment Consulting

• Technical, income, and resource eligibility criteria for Long Term Care (LTC) and Medicaid Waiver Programs

• Cabinet-approved standards for evaluating assets, spend-downs, and qualifying income

• Determinations of hardship exemptions and resource penalties related to waiver and LTC eligibility

✅ Policy & Regulation Expertise

• Interpretation and application of 907 KAR Title Medicaid Regulations

• Familiarity with internal CHFS Department for Community Based Services (DCBS) policies

• Understanding of how CHFS Medicaid caseworkers are trained to apply rules in real-world cases

✅ Third Party Liability & Insurance Issues

• Guidance on handling Medicaid-related third-party liability (TPL) scenarios

• Clarification of coverage intersections, private insurance conflicts, and Cabinet enforcement expectations

✅ Fraud Investigation & Legal Risk Support

• Consulting on CHFS Office of Inspector General (OIG) protocols for public assistance fraud investigations

• Help attorneys understand the process, timeline, and documentation used in OIG cases

✅ Hearings & Legal Process Support

• How to properly request a KY Medicaid Administrative Hearing

• Guidance on filing exceptions to a Recommended Order following a hearing

• Help reviewing state responses, hearing officer findings, and appeal timelines

Who We Help

• Attorneys representing clients denied or terminated from Medicaid programs

• Families seeking appeals or hardship waivers for LTC or waiver eligibility

• Law firms navigating fraud investigations or defending eligibility

• Healthcare attorneys requiring Medicaid-specific insight for compliance or risk mitigation

Why Legal Professionals Choose RCOM

• Specialized in Kentucky Medicaid—not general healthcare consulting

• Decades of experience with state systems, Cabinet policies, and procedural timelines

• Clear communication, thorough documentation, and always grounded in current KY regulations

• Independent, unbiased consulting tailored to the needs of legal professionals