i dont know the answers to your questions about if the alj can overule medicaid guidelines but i just wanted to say that i think you did a great job and gave it the good fight. You should have directly asked the insurance people about wether they ever received the paperwork from the orthotics place for authorization and reminded them that they were under oath.ha! They are all full of doggy diamonds. Did Alan get another pair of shoes paid for by the insurance company? Its not clear at the end of your post it seems he got another pair of shoes but i might be misinterpreting. I wish you luck and hope he gets the orthotics. This is where our "ADVOCACY" organizations should be involved in the fight.