State Fair Hearing Process

hearing

If you have any problems about the care you are getting, you must first request an appeal to Molina. If you are unhappy with Molina's decision, you may directly appeal to the Michigan Department of Health and Human Services (MDHHS) through the State's Fair Hearing process. This must be done within 120 calendar days of the final appeal resolution notice. Molina Healthcare will include a State hearing request form with a self-addressed stamped envelope with our decision. Below are the steps for the State's Medicaid Fair Hearing process.

 

 

Step 1 Please call Member Services at (888) 898-7969, Monday - Friday, 8 a.m. to 5 p.m. (TTY: 711); or Michigan ENROLLS at (888) 367-6557 (TTY: (888) 263-5897); or Michigan Office of Administrative Hearings and Rules at (800) 648-3397 to have a Hearing Request form sent to you.  You may also call to ask questions about the hearing process.

Your written request must include your name, address, Member number, reasons for appealing and any evidence you want reviewed, such as medical records, doctors’ letters, or other information that explains why you need the item or service. Please call your doctor if you need this information.
Step 2 Fill out the request form and mail it to the address listed on the form. Molina will help you complete and send in the request form.
Step 3 A hearing will be scheduled. The State will hold a hearing. You may attend the hearing in person or by phone. You will be asked to tell the state why you disagree with our decision. You can ask a friend, relative, advocate, provider, or lawyer to help you. 
Step 4 The results will be mailed to you from Michigan Department of Health and Human Services after the hearing is held. The written decision will explain if you have additional appeal rights. If your complaint is taken care of before your hearing date, you must call to ask for a Hearing Request Withdrawal Form. You can call (800) 648-3397 to request this form.  The address to request this Hearing Request Withdrawal form is:

Michigan Department of Health and Human Services

Michigan Office of Administrative Hearings and Rules

P.O. Box 30763

Lansing, MI 48909

Attn: Hearings/Appeals 

(800) 648-3397