State Fair Hearing

Medical symbol caduceus snake with stick
State Fair Hearing

In addition to the appeal process offered by Molina Healthcare, members have the right to request a Fair Hearing from the State of New Mexico within ninety (90) calendar days from the date of Molina’s final decision. Molina SCI members must exhaust the Molina appeal process before they can ask for a Fair Hearing. Members may request a State Fair Hearing by contacting the New Mexico Human Services Department’s Fair Hearings Bureau within ninety (90) days after the Molina Healthcare denial.

If a member is currently receiving a medical service that is going to be reduced or stopped, he/she may continue to receive the same medical service until the hearing if the hearing is requested within thirteen (13) days from the date of the final denial.

If you are not happy with Molina’s final decision, you may write or call the Fair Hearings Bureau to request a Fair Hearing.

New Mexico Human Services Department
Fair Hearings Bureau
PO Box 2348
Santa Fe, NM 87504-2348
In Santa Fe: (505) 476-6213 or toll-free (800) 432-6217 then press Option 6

Members have the right to have someone who knows about the case to attend the hearing with the member, if he/she wishes. Members may also seek legal counsel to represent them.