Fair Hearing-Alternative Dispute
State Fair Hearing
What is a State Fair Hearing?
A hearing provided by a state level administrative law judge when a decision has been made to deny, reduce, suspend or terminate services for a person who has Medicaid.
How do I request a State Fair Hearing?
You must make all requests in writing to the Administrative Tribunal within 90 days of receiving a notice letter, a letter informing you of a reduction, suspension or termination of services.
Administrative Tribunal
Michigan Department of Community Health
P.O. Box 30195
Lansing, MI 48909
Is there a special form that I need to complete when filing for a state hearing?
You can call AAM Customer Service at 1-888-482-8269 or Department of Community Health 1-877-833-0870 to request a Fair Hearing Request form or to ask for assistance in completing the form.
Do I need an attorney if I request a hearing?
Please note that prior to the actual hearing you may choose to have another person represent you or participate in the hearing. This person can be anyone you choose, including a service provider and/or an attorney. This person may request a hearing for you. You may have to give this person written permission to represent you. You have the right to present facts to support your case in a hearing. You may choose to have an attorney represent you at the hearing but it is not necessary.
What if I have already filed for a local appeal?
You can file for a State hearing at the same time you file a local appeal. You can file an appeal only or a State Fair Hearing only. You have many options.
If you need an answer right away and feel your situation could become worst by waiting too long, you can request a hearing to be conducted quickly by calling: 1-877-833-0870.
How do I know the process is going to be fair?
The hearing is conducted by an Administrative Law Judge from the Administrative Tribunal, a branch of the State government.
If I am already receiving services, what happens with my services during the local appeal or state hearing process?
If you request a hearing before services are scheduled to be changed, your services may continue until a judge makes a ruling on your case.
In order to continue services, you must contact AAM Customer Service by the date included on the letter you received to deny, suspend, terminate or reduce your services. If the judge does not rule in your favor, you may be asked to pay for the services received.
What is the Michigan Department of Community Health (MDCH) Alternative Dispute Resolution?
This process is available for persons without Medicaid that are unhappy with the local appeal process.
How do I know when to use the Alternative dispute Resolution process?
If you do not agree with an appeal decision made at the local dispute level. (You have 10 days from receiving the written notice to file for an MDCH Alternative Dispute Resolution.)
OR
If you do not receive an Appeal Disposition letter within 45 days of filing an Appeal.
OR
You do not receive a Grievance Disposition letter within 60 days of filing a grievance. (You have five days to file after receiving the disposition letter).
You may contact AAM at 1-800-448-5498 or send a written request to:
Michigan Department of Community Health
Division of Program Development, Consultation and Contracts
Bureau of Community Mental Health Services
ATTN: Request for DCH Level Dispute Resolution
Lewis Cass Building-6th FL
Lansing, MI 48913
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