Medicaid applicants and recipients who are affected by an adverse action on their case, taken by the DPA , may be entitled to a fair hearing. The request may be made to any employee of DPA in writing, by telephone, via mail and in person. DPA may also receive a request for a Fair Hearing through the FFM . Requests through the FFM are monitored by the Contracted Service Quality Assurance Unit (CSQA).
In addition, Medicaid recipients who are denied coverage of a specific medical need, including nursing home care by the DHCS , may be entitled to a fair hearing.
For fair hearing availability, policies, and procedures, see Administrative Procedures Manual Section 117.
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