Requesting a Fair Hearing
• If you disagree with Medicaid's denial, reduction, suspension, or termination
of service, you may request a Fair Hearing. A Fair Hearing allows you and
Medicaid to give information about your situation to a Hearing Officer. The
Hearing Officer is a neutral party who makes a decision on your appeal. There is
no charge for a Fair Hearing.
• Medicaid must receive your request within 120 calendar days from the Notice
Date.
• You may represent yourself or have the help of another adult. The adult can
be a friend, family member, or lawyer. Medicaid has provided the names of some
agencies that may be able to help you. (See below).
• The request for a Fair Hearing must include: (1) your name, address, telephone
number, (2) Medicaid number; and (3) if someone is helping you, the name,
telephone number and address of the adult who will help you (the "authorized
representative"). You must sign the request unless you are unable to do so because
of your disability. You may use the enclosed form to request a Fair Hearing.
• If you want your services to stay the same during Fair Hearing process, you
must: 1) ask for a hearing not more than 10 calendar days after the Date of
Action (shown on the Notice of Decision); and 2) you must ask that your
services stay the same. (During the Fair Hearing process, your services will be
continued) You may use the enclosed form to do this.
• LIBERTY may ask you to pay back the cost of the continued services if you
lose your appeal.
• After you have requested a Fair Hearing, Medicaid will contact you within 10
days to arrange a Hearing Preparation Meeting (HPM). The meeting will be
by telephone. The goal of this meeting is to try to resolve your appeal. LIBERTY
will explain its decision and give you the chance to provide more information. If
you and LIBERTY cannot agree, you may go to a Fair Hearing. A Hearing
Preparation Meeting (HPM) is optional. You do not have to take part in a HPM.
You can let Medicaid know you want to go directly to a Fair Hearing and have a
Hearing Officer decide your appeal.
To find out more about Medicaid appeals, you may go to the Nevada Department of
Health and Human Services, Division of Health Care Financing and Policy's Medicaid
Service Manual Chapter 3100 Hearings at: http://dhcfp.nv.gov.
If you cannot afford legal counsel, one of the Legal Services programs listed below may
be able to help. Nevada Legal Services, Inc. (Reno) Washoe County: (775) 284-3491
Nevada Legal Services, Inc. (Las Vegas) Clark, Lincoln, Nye, and Esmeralda Counties:
(702) 386-0404 or (866) 432-0404 TDD: (702) 386-1059
Nevada Legal Services, Inc. (Elko) Elko County: (775) 753-5880