Member Appeal Rights and State
Fair Hearings
Members have the right to appeal if we deny their request for medical
care. An appeal is when you write or call us and ask us to look again
at a decision we made to see if the right decision was made. If your
request for health care is denied, you will get a letter from us telling
you why. The letter will tell you how you can appeal to us.
After we look at your appeal, we will send you a letter telling you what we decided about your appeal. If you are still unhappy with our decision after your appeal, you may ask for a State Fair Hearing with Medicaid. Your doctor or other person representing you may also ask for a State Fair Hearing.
We will send you a letter to tell you how and when to ask for the State Fair Hearing. We will also give you the form to use if you want to ask for a State Fair Hearing. You must mail this request to the address on the form.
If you would like information on Appeals and State Fair Hearings,
please call the Appeal Coordinator at
