Medicaid State Fair Hearings in New Mexico
Learn about your rights to file an external appeal.
If you or an authorized representative asked for an appeal and got a resolution letter saying our decision stayed the same — and you do not agree — you have the right to ask for a State Fair Hearing. You or an authorized representative can also ask for a State Fair Hearing, if you asked for an appeal but did not get a resolution letter, and more than 30 days have passed since you filed your appeal.
State Fair Hearings are at no cost to the member.
You may be able to have your services continue while your case is reviewed. To ask for continued services, call Molina Member Services at (844) 862-4543 (TTY: 711), Monday through Friday, 8 a.m. to 5 p.m. local time.
State Fair Hearing
A State Fair Hearing lets a judge who is not part of Molina Healthcare review your case.
You must ask for a State Fair Hearing within 90 days from the date on the letter telling you the appeal decision. The judge’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 New Mexico Health Care Authority (HCA) for a fast (expedited) hearing.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.
New Mexico Health Care Authority Department
Office of Fair Hearings
P.O. Box 2348
Santa Fe, NM 87504-2348
If you need help asking for a State Hearing, we can help. We offer language services at no cost to the member. Call Member Services at (844) 862-4543 (TTY: 711), Monday through Friday, 8 a.m. to 5 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.