State Fair Hearing
If you are unhappy with an appeal decision that was made not in your favor, you or Authorized Representative can ask for a State Fair Hearing. You can ask for a State Fair Hearing within sixty (60) calendar days of Molina’s notice of appeal resolution.
At a State Fair Hearing, there will be an administrative law judge who makes a decision after a hearing.
You can make a request to the Department of Health and Human Services for a State Fair Hearing in writing, in person or by phone. If you need help with your appeal or want to file by phone you can call the Iowa Department of Health and Human Services (HHS) office by contacting the HHS Appeals Section at (515) 281-3094.
To file in writing, please send to:
Department of Human Services
Appeals Section, 5th Floor
1305 E Walnut Street
Des Moines, IA 50319-0014
Email: appeals@dhs.state.ia.us
You can also call Molina’s Member Services Department and ask for help with a State Fair Hearing request. The Department of Human Services will let you know in writing when they have received your State Fair Hearing request. They will let you know of their State Fair Hearing decision in writing as well.
When your appeal is about services you were getting, but those services ended or were decreased, you can continue getting services during the State Fair Hearing. If you continue getting services, there will be no change in your services until a final State Fair Hearing decision is made. Please be sure to tell us if you want your services to continue.
If you continue getting services and the services are still denied after a State Fair Hearing, we may ask that you pay for the cost of those services. We will not take away your Medicaid benefits. We cannot ask your family or legal representative to pay for the services.
Molina will meet the terms of the State Fair Hearing decision made by the Department of Human Services. The Department of Human Services’ decision in these matters will be final. If the State Fair Hearing decision is to reverse an Adverse Benefit Determination made by Molina, Molina will pay for all costs associated with the hearing.