State Fair Hearing
If you are unhappy with an appeal decision that was made not in your favor, you or Authorized Representative can ask for a State Fair Hearing. You can ask for a State Fair Hearing within ninety (90) calendar days of Molina’s notice of appeal resolution.
You must first complete your plan-level appeal before asking for a State Fair Hearing with the Nevada Medicaid Hearings Unit. You can ask for a State Fair Hearing by sending your request in writing to:
Nevada Division of Medicaid
Nevada Medicaid Hearings Unit
1100 East William Street-Suite 101
Carson City, NV 89701
Fax # (775) 684-3610
Email: dhcfphearings@dhcfp.nv.gov
You can also call Molina’s Member Services Department and ask for help with a State Fair Hearing request. The Nevada Medicaid Hearings Unit will let you know in writing when they have received your State Fair Hearing request. They will let you know of their State Fair Hearing decision in writing as well.
When your appeal is about services you were getting, but they ended or were decreased, you can continue getting services during the State Fair Hearing. If you continue getting services, there will be no change in your services until a final State Fair Hearing decision is made. Please be sure to tell us if you want your services to continue.
If you continue getting services and the services are still denied after a State Fair Hearing, we may ask that you pay for the cost of those services. We will not take away your Medicaid benefits. We cannot ask your family or legal representative to pay for the services.
Molina will meet the terms of the State Fair Hearing decision made by the Nevada Medicaid Hearings Unit. The Nevada Medicaid Hearings Unit’s decision in these matters will be final. If the State Fair Hearing decision is to reverse an Adverse Benefit Determination made by Molina, Molina will pay for all costs associated with the hearing.