State Administrative Hearing
If you disagree with Molina Healthcare’s appeal decision, you can ask for a State Administrative Hearing. You must complete Molina Healthcare’s appeal process before you can have a hearing. You must ask for a hearing within 120 calendar days of the date on the appeal decision letter that says the denial was upheld. When you ask for a hearing, you need to say what service was denied, when it was denied and the reason it was denied. Your provider may not ask for a hearing on your behalf.
You may ask for a faster decision if your health is at risk. A judge will make a decision within four working days after receiving the request. If the judge decides your health is not at risk, the Office of Administrative Hearings will call you and send you a letter within four working days of the request. Your hearing will change to the standard timeframe.
To ask for a State Administrative Hearing:
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Contact the Office of Administrative Hearings (OAH) directly at (800) 583-8271, or
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Write to them at:
PO Box 42489
Olympia, WA 98504-2489You may consult with a lawyer or have another person represent you at the hearing. If you need help finding a lawyer, check with the nearest Legal Services Office, or call the NW Justice CLEAR line at (888) 201-1014 or visit their website at www.NWJustice.org.