The Health and Hospitals (HH) section conducts fair hearings for the Department of Health and Hospitals. This section is staffed with impartial administrative law judges who conduct the fair hearings and make recommended decisions to the Department of Health and Hospitals. This page has been designed to allow you easy access to information about what to expect at the hearing and forms you can use. If you have any suggestions for additions to this page we hope you will contact us.

 
Click Here to Visit Department of Health and Hospitals website
 

  
Appeal Request Form
 
  
Click Here to Fill out the Appeal Request Form

 

  
WHAT TO EXPECT AT THE FAIR HEARING ON YOUR MEDICAID APPEAL
 
  
Download the Presentation

  
 

  
Judicial Review
 

Use this document to view Provider Review Rights and Recipient Review Rights.

  
Download the Document

  
 

  
Request for Continuance
 

You may click the hyperlink below to print a Request for Continuance form.

  
Download the Form

  
 

  
Waiver of Decision Due Date
 

You may click the hyperlink below to print a Waiver of Decision Due Date form.

  
Download the Form

  
 

  
Response to Conditional Order
 

You may click the hyperlink below to print a Response to Conditional Order of Dismissal form.

  
Download the Form

  
 

  
Request for Withdrawl of Appeal Request
 

You may click the hyperlink below to print aRequest for Withdrawl of Appeal Request form.

  
Download the Form