Medicaid State Fair Hearing
If you have any problems about the care you are getting, you must first request an appeal to Passport. If you are unhappy with Passport’s decision, you may appeal through the State’s Fair Hearing process. A Fair Hearing is your opportunity to give more information and facts, and to ask questions about your decision before an administrative law judge. The judge in your Fair Hearing is not a part of Passport in any way. This must be done within 120 calendar days of the final appeal resolution notice. Below are the steps for Kentucky’s Medicaid Fair Hearing process.
Step 1 Submit a request in writing for a State Fair. Hearing. The written request must include:
Your name, address, and phone number
Specify reason for appealing
Date of service and type of service denied
Any evidence you want reviewed, such as medical records, doctor’s letters, or other information that explains why you need the item or service. Please call your doctor if you need this information.
Step 2 A hearing will be scheduled. A hearing officer from the Kentucky Cabinet for Health and Family Services will hold a hearing. You may attend the hearing in person or request to have the hearing by phone. You will be asked to tell the state why you disagree with our decision. You can ask a friend, relative, advocate, provider, or lawyer to help you.
Step 3 Those attend the hearing include:
• Your authorized representative (If chosen)
• Passport representative
• Hearing officer from the Kentucky Cabinet for Health and Family Services
Step 4 At the hearing, Passport will explain why we made our decision. You or your representative tells the hearing officer why you think Passport made the wrong decision. Then the hearing officer will decide if they agree or disagree with Passport’s decision.