Independent medical reviews in Mississippi

MSCAN only: State Fair Hearing

A State Fair Hearing lets a Hearing Officer who is not part of Molina Healthcare review your case.

You must ask for a State Fair Hearing within 120 days from the date on the letter telling you the appeal decision. The Hearing Officer's decision is final, and we must follow it.

If waiting for a State Hearing could harm your life, health, or ability to function, you, your provider, or your authorized representative can ask the Mississippi Division of Medicaid for a fast (expedited) hearing. They must make a decision no later than 3 business days after getting your complete case file from Molina Healthcare.

You can read more in your Member Handbook.

How can you ask for a State Fair Hearing?

You can file a State Fair Hearing in different ways

• Online: Visit www.medicaid.ms.gov 
• Phone: Call (800) 421-2408
• Mail: Fill out the form that came with your appeal resolution letter and send it to:

By mail: Mississippi Division of Medicaid
Office of Administrative State Hearings
P.O Box 2222
Jackson, MS 39225

If you need help asking for a State Hearing, we can help. We offer no-cost language services. Call Member Services at (844) 305-6408, Monday through Friday, 8:00 a.m. to 5:00 p.m. local time.

Important Timeframes

You must ask for a State Fair Hearing within 120 days of getting the letter telling you the appeal decision.

Cost

You do not have to pay for a State Fair Hearing.

You can read more about these rights in your Member Handbook.

CHIP Members Only: Independent External Review

If your appeal is denied and you still do not agree with Molina’s decision, or if you do not receive an appeal resolution letter on time, you, or someone acting for you with your written permission, can ask for an Independent External Review.

How to Ask for an Independent External Review:

• When you ask for an Independent External Review, the MLS Group of Companies reviews the decision that was made by Molina.
• You may ask for an Independent External Review any time within 120 calendar days after you get our notice of plan appeal resolution unless there is an acceptable reason for a delay.
• You must finish your plan appeal process first before you can ask for an Independent External Review.

To ask for an Independent External Review, you may submit your request to the Molina Appeals and Grievance department. The Appeals and Grievance team will submit the Independent External Review to the MLS Group of Companies for review; the MLS Group of Companies will contact you when the review is completed. Please submit your request to the following:

Independent External Review Request

Attn: Member Grievance & Appeals

c/o Firstsource PO Box 182273 Chattanooga, TN 37422

Fax Number: (844) 808-2407

The MLS Group of Companies does not have any ties to Molina. The MLS Group of Companies will tell you in writing that they received your request. They will complete the independent external review within 90 days of the date of your request for an external review, and will contact you in writing about the decision.

Molina will meet the terms of the Independent External Review decision made by the MLS Group of Companies. The decision made by the MLS Group of Companies in these matters will be final.

If you have questions, call us at (844) 809-8438, (TTY: 711). For more information on your rights, review the Grievance and Appeal section in your Member Handbook.