State Fair Hearings

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State Fair Hearings

A Medicaid State Fair Hearing (a type of trial) is provided by a state level administrative law judge if you ask for one when a decision has been made to deny, reduce or suspend services if you have Medicaid. Recovery Pathways LLC’s Recipient Rights/Customer Services staff can help you. Call us at 989-928-3566.

You must ask for this hearing in writing to the Michigan Administrative Hearing System (MAHS) within 90 calendar days of receiving a notice letter, a letter informing you of a reduction, suspension or termination of services.  The letter should be mailed to:

MICHIGAN ADMINISTRATIVE HEARING SYSTEM (MAHS)
FOR THE DEPARTMENT OF COMMUNITY HEALTH
P.O. BOX 30763
LANSING, MI 48909

You can click on the link below for a copy of the Request for Hearing form:

http://www.michigan.gov/mdch/0,1607,7-132-2946_5093-16825–,00.html

You can click on the link below for more information on Medicaid Fair Hearings: Rights and Responsibilities:

http://www.michigan.gov/documents/ADMINISTRATIVEHEARINGS_81632_7.brochure.pdf

You can call Customer Services at 989-928-3566 or MAHS at 1-877-833-0870 to request a State Medicaid Fair Hearing Request form or to ask for help in completing the form.

Please note that before the actual hearing you may choose to have another person stand in for you or take part in the hearing. This person can be anyone you choose, including a service provider and/or an attorney. This person may request a hearing for you. You may have to give this person written permission to represent you. You have the right to give facts to support your case in a hearing. You may choose to have an attorney represent you at the hearing, but it is not necessary.

You can file for a Medicaid State Fair Hearing at the same time you file a local appeal. Or you can file an appeal only or a Medicaid State Fair Hearing only. You have many options.

If you need an answer right away and feel your situation could become worse by waiting too long, you can request a hearing to be conducted quickly by calling: 1-877-833-0870.

The hearing is conducted by an Administrative Law Judge from MAHS, a part of the State government. If you request a hearing before services are scheduled to be changed, your services may continue until a judge makes a decision on your case. In order to continue services, you must contact Customer Services by the date included on the letter you received to change (deny, suspend, terminate or reduce) your services. If the judge does not rule in your favor, you may be asked to pay for the services you used, up to your ability to pay.

Michigan Department of Health and Human Services (MDHHS) Alternative Dispute Resolution

This is available to people without Medicaid who are unhappy with the local appeal process. If you do not agree with an appeal decision made within Recovery Pathways LLC’s local process. You have 10 days from when you get the written notice to file for an MDHHS Alternative Dispute Resolution.

You may contact the Recipient Rights/Customer Services Department at 989-928-3566 or send a written request to:

Michigan Department of Health and Human Services
Division of Program Development, Consultation and Contracts
Bureau of Community Mental Health Services
ATTN: Request for DCH- Level Dispute Resolution
Lewis Cass Building – 5th Floor
320 S. Walnut St.
Lansing, MI 48913