State Fair Hearing
Members have the right to askfor 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:
MolinaHealthcare of Texas
Attention: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 ofinformation with the date, time and location of the Hearing will be sent to themember. Members may write or call toll-free at any time during the appealsprocess (866) 449-6849.
Most State Fair Hearings are held bytelephone and the member or member representative will be able to discuss theservices being appealed.
Members can bring someone whoknows about the case to attend the hearing. Members may also bring someone elseto represent them. This person can be a doctor, a friend or a relative.
TheTexas Health and Human Services Commission will make a final decision within 90days from the date that the Hearing was requested.