Independent medical reviews in Nevada

 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 an external appeal. You or an authorized representative can also ask for an external appeal, if you asked for an appeal but did not get a resolution letter, and more than 30 calendar days have passed since you filed your appeal.

You can ask for a State Fair Hearing.

External Appeals are available at no cost to you.

You may be able to have your services continue while your case is reviewed. To ask for continued services, call Molina Member Services at (833) 685-2102 (TTY: 711), Monday through Friday, 8 a.m. to 6 p.m. local time.

State Fair Hearing

A State Fair Hearing lets a judge who is not part of Molina Healthcare look at your case again. You must ask for a State Fair Hearing within 90 calendar days from the date on the notice that tells you the appeal decision. The judge’s decision is final, and we must follow it.

If waiting for a State Fair Hearing could harm your life, health, or ability to do daily activities, you, your provider, or your approved helper can ask the Nevada Medicaid Hearing Unit for a fast hearing. They must make a decision no later than 3 business days after they get your full 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:

• Mail: Fill out the form that came with your appeal resolution letter and send it to:
  Nevada Medicaid Hearings Unit
  9850 Double R Blvd. Suite 200
  Reno, NV 89521
• Email: medicaidhearings@nvha.nv.
• Phone: Call (755) 684-3604
• Fax: Fill out the form that came with your appeal resolution letter and fax it to (775) 684-3610.

If you need help asking for a State Hearing, we can help. We offer language services at no cost to you.

Call Member Services at (833) 685-2102 (TTY: 711), Monday through Friday, 8 a.m. to 6 p.m., local time.

Important Timeframes

You must ask for a State Fair Hearing within 90 calendar days from the date on the notice that tells 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.