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Members

State Fair Hearing

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Members have the right to ask for a Fair Hearing if they disagree with a decision made by Molina Healthcare. A Fair Hearing can be requested at any time even if an appeal hasn’t been filed with Molina Healthcare.  A Fair Hearing must be requested within 120 days from the date issued in the letter from Molina Healthcare, stating services have been changed. If a Fair Hearing is not requested within 120 days, rights to a Fair Hearing may be lost. To request a Fair Hearing the member or member’s representative must contact Molina Healthcare in writing or by telephone at:

Molina Healthcare of Texas

PO Box 165089

Irving Texas 75016

Attention: Member Inquiry Research and Resolution Unit

Fax (877) 816-6416

Phone (877) 665-4622 ext. 201050

TTY (800) 662-4954

Members have the right to continue any service being received until the final hearing decision, if a Fair Hearing is requested within ten (10) days from receipt of the adverse determination letter from Molina Healthcare. If a State Fair Hearing is not filed within 10 days, the services being appealed will be discontinued.

If a Fair Hearing is requested, a packet of information with the date, time and location of the Hearing will be sent to the member. Members may write or call toll-free at any time during the appeals process​  (877) 665-4622 ext. 201050.

Most Fair Hearings are held by telephone and the member or member representative will be able to discuss the services being appealed.

Members can bring someone who knows about the case to attend the hearing. Members may also bring someone else to represent them. This person can be a doctor, a friend or a relative.

The Texas Health and Human Services Commission will make a final decision within 90 days from the date that the Hearing was requested.​

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