Medicaid Fair Hearing
If you are not satisfied with a decision made by Medicaid, you may request what is called a “Fair Hearing.” This is a legal proceeding, heard by an administrative Law Judge (ALJ). Both your arguments and those of the Medicaid department are presented, and the judge makes a decision.
There are numerous reasons why you might request a Fair Hearing. Medicaid may deny your application. You may disagree with the type of care, or the amount of care you are granted. Also, Medicaid requires you to contribute toward the cost of your care from your monthly income. There may be a difference of opinion about what your monthly contribution should be.
If you want to contest any of these (or other) issues, you are not permitted to go to civil court right away. You must first request a Fair Hearing. If you still disagree with the judge’s decision, you are then permitted to pursue other remedies in civil court.Download our Nursing Home Medicaid Handout