Fair Hearings – Medicaid

Applying for Medicaid or any other government benefits can be challenging. If an application for Medicaid or other government benefits is denied, it is important to understand that you have the right to appeal the denial to the State in an administrative proceeding called a Fair Hearing. (NOTE_- You must also request an internal appeal of an adverse decision with your healthcare provider in addition to requesting a NYS Fair Hearing)

According to the New York State Office of Temporary and Disability Assistance (OTDA), a fair hearing is your chance to dispute the decision made by the local offices or agencies in front of an Administrative Law Judge (ALJ) employed by the New York State Office of Temporary and Disability Assistance, Office of Administrative Hearings.   After a hearing at OTDA, an Administrative Law Judge will then issue a recommendation to the Commissioner of OTDA that will uphold or overturn the local office decision. If the original decision is overturned, the Administrative Law Judge may make a recommendation ordering the local office to take appropriate action concerning your government benefits.

Requesting a fair hearing can be done in one of the following ways:

  • Online request form;
  • Mail or fax a printable request form;
  • Request by telephone; or
  • Request in person (applicable in NYC and Albany only).

Online request forms are located on the New York State Office of Temporary and Disability Assistance website, as is the mail or fax printable versions of the form. Request forms are available in eight different languages for your convenience, including:

  • English;
  • Arabic;
  • Chinese;
  • Haitian-Creole;
  • Italian;
  • Korean;
  • Russian; and
  • Spanish.

 

To request a fair hearing by telephone, a call can be placed to (800) 342-3334, statewide. If you are planning to fax your request form, it can be done so by dialing (518) 473-6735, or you can mail the form to the following address:

NYS Office of Temporary and Disability Assistance
Office of Administrative Hearings
Managed Care Hearing Unit
P.O. Box 22023
Albany, New York 12201-2023

To request a fair hearing in person, you must go to the Office of Temporary and Disability Assistance, Office of Administrative Hearing in either Brooklyn or Albany. Upon the processing of your fair hearing request, the New York State Office of Temporary and Disability Assistance will send you an OAH-4420 Acknowledgement of a Fair Hearing Request via US mail. Thereafter, a Notice will be sent scheduling your Fair Hearing with the date, time and location of the hearing.

An available option that you may be able to choose is a State Supplement Program (SSP) fair hearing. This type of fair hearing is conducted via telephone, unless an in-person hearing is requested on your request form. This process may be more beneficial for you, especially if you are unable to travel.

Whether for yourself or on behalf of a loved one, applying for a fair hearing and handling other elder law matters can seem to be overwhelming. The legal professionals at Hobson-Williams P.C. will advise you on the options available to you and help you through the fair hearing process. Call (718) 210-4744 to contact one of our experienced elder law attorneys and learn how Hobson-Williams P.C. can help you gain the peace of mind that comes from being prepared for the future.

Written by Tanya Hobson Williams

Appointed to the bench by the Board of Trustees in 2008, and elected in 2009, Tanya Hobson-Williams was the first African-American Female Justice in the Incorporated Village of Hempstead. Tanya Hobson–Williams obtained her B.A. in Government and Politics from St. John’s University and her law degree from Benjamin N. Cardozo School of Law.

Tanya Hobson-Williams has an active elder law practice assisting senior citizens in obtaining Medicaid for Home Care and Nursing Home Care. She routinely lectures at senior citizen centers, assisted living facilities, law schools and counsels families on a variety of topics of concerns to families caring for the elderly.

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Author: Tanya Hobson Williams

Appointed to the bench by the Board of Trustees in 2008, and elected in 2009, Tanya Hobson-Williams was the first African-American Female Justice in the Incorporated Village of Hempstead. Tanya Hobson–Williams obtained her B.A. in Government and Politics from St. John’s University and her law degree from Benjamin N. Cardozo School of Law. Tanya Hobson-Williams has an active elder law practice assisting senior citizens in obtaining Medicaid for Home Care and Nursing Home Care. She routinely lectures at senior citizen centers, assisted living facilities, law schools and counsels families on a variety of topics of concerns to families caring for the elderly.

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