State Fair Hearing

In addition to the grievance processes offered by Molina Healthcare, members have the right to request a Fair Hearing from the State of Texas at any time during the process. They have a right to request a Fair Hearing even if a complaint or grievance hasn’t been filed with Molina Healthcare and/or if a health care service the member or the member’s doctor requested has been denied, delayed or modified. Members may request a State Fair Hearing by contacting us toll-free at (866) 449-6849 TTY (English) (800) 735-2989, (Spanish) (800) 662-4954 to tell us about your problem. A Molina Member Service Advocate can help you file a fair hearing; just call 713-418-1999, Ext. 204016 if you are in the Houston area or 210-366-6500, Ext. 203011 if you are in the San Antonio area within ninety (90) days after the order or action complained.

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 ten (10) days from the date the denial letter was postmarked or personally delivered to the member, or before the date of medical service is needed.

Members may write or call toll-free at any time during the grievance process. Members have the right to bring 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. For more information on obtaining free legal aid, contact at their toll-free number.