Members have the right to ask
for a State Fair Hearing if they disagree with a decision made by Molina Healthcare.
A State Fair Hearing can be requested after you complete Molina Healthcare's appeal process. A State Fair Hearing must be requested within 120 days from the date on the Appeal Resolution letter from Molina Healthcare. If a State Fair Hearing is not requested within 120 days, rights to a State Fair Hearing may be lost. To request a State Fair Hearing the member or member's representative must contact Molina Healthcare in writing or by telephone at:
Healthcare of Texas
Member Resolution Team
Members who requested and received continued services during the appeal process have the right to continue any service being received until the final hearing decision. To continue receiving services during the State Fair Hearing, the Member must request the State Fair Hearing within ten (10) business days of the date on the Appeal Resolution letter from Molina Healthcare. If a State Fair Hearing is not filed within ten (10) business days, the services being appealed will be discontinued.
If a State 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 (866) 449-6849.
Most State 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.
Texas Health and Human Services Commission will make a final decision within 90
days from the date that the Hearing was requested.