State Fair Hearing
In addition to the grievance processes offered by Molina Healthcare, members have the right to request a Fair Hearing from the State of Wisconsin at any time during the process. They have a right to request a Fair Hearing even if a complaint or grievance hasn’t been filed with Molina Healthcare and/or if a health care service the member or the member’s doctor requested has been denied, delayed, or modified. Members may request a State Fair Hearing by contacting the State of Wisconsin Division of Hearings and Appeals (DHA) within ninety (45) days after the order or action complained of:
If you want to talk to someone outside of Molina Healthcare Health Plan about the problem, call the HMO Enrollment Specialist at (800) 291-2002. The Enrollment Specialist may be able to help you solve the problem, or can help you write a formal grievance to Molina Healthcare Health Plan or to the BadgerCare Plus and Medicaid SSI programs.
You may also file a complaint with the Wisconsin BadgerCare Plus and Medicaid SSI Program. Please call Molina Healthcare’s Member Advocate if you need help to write a formal grievance to Molina Healthcare Health Plan or to the BadgerCare Plus and Medicaid SSI programs.
The address to complain to the Wisconsin BadgerCare Plus and Medicaid SSI Programs is:
BadgerCare Plus and Medicaid SSI
If you want a Fair Hearing, send a written request to:
Managed Care Ombuds
P.O. Box 6470
Madison, WI 53716-0470
Department of Administration
Division of Hearings and Appeals
P.O. Box 7875
Madison, WI 53707-7875
The hearing will be held in the county where you live. You have the right to bring a friend or be represented at the hearing. If you need a special arrangement for a disability, or for English language translation, please call (608) 266-3096 (voice) Or (608) 264-9853 (hearing impaired).
We cannot treat you differently than other members because you request a Fair Hearing. Your health care benefits will not be affected. If you need help writing a request for a Fair Hearing, please call either the BadgerCare Plus and Medicaid SSI Ombuds at (800) 760-0001 or HMO Enrollment Specialist at (800) 291-2002.