FFS State Fair Hearings

Member FFS SFH

• What is a FFS state fair hearing?

  The FFS state fair hearing is processed by the Office of Administrative Hearings (OAH). It is an opportunity for the FFS member to speak about the healthcare service decision made by the Medicaid agency. The member and the Medicaid agency meet before an impartial administrative law judge. He or she will issue an initial order based upon what is presented by you and the Medicaid agency at the hearing. The fair hearing process is for members currently receiving services.

• How do I submit a state fair hearing request regarding a FFS decision?

  The member or member’s authorized representative’s state fair hearing request may be submitted verbally or in writing. 
  
  FFS Beneficiary - Request for Medicaid Fair Hearing

  • To submit a FFS state fair hearing request verbally: 1-800-766-9012

  • To submit a FFS state fair hearing request by fax send to:

    (785) 296-4848 (Requests greater than 20 pages cannot be faxed).

  • To submit a FFS state fair hearing request by mail send to:
    Office of Administrative Hearings
    1020 S. Kansas Ave.
    Topeka, KS 66612
     

• Is there a deadline for filing a FFS state fair hearing?

  Yes, the FFS state fair hearing request must be filed within 33 calendar days from the date on the notice of action.

• What is the process once a FFS state fair hearing request has been submitted?

  The Medicaid Agency will submit documents related to the decision about your services to OAH prior to the state fair hearing. You may also submit documents to OAH prior to the state fair hearing. OAH will schedule a state fair hearing about the Medicaid Agency's decision within one or two months of the date of your state fair hearing request. OAH must reach its decision usually within 30 calendar days of the state fair hearing date.
  
  If you ask for an expedited (fast) state fair hearing due to an urgent medical need, you must submit medical documents at the same time that you ask for a fast state fair hearing.  The Medicaid Agency will review medical documents and approve or deny your request.  If approved, the hearing will be scheduled as soon as possible. If denied, your hearing request will be processed in the usual amount of time.

• What documents do I need to submit for my FFS state fair hearing?

  Full name, address, telephone number, a copy of the notice about which you are appealing. If your address changes during the state fair hearing process it is your responsibility to give that address change to OAH.

  In the FFS state fair hearing process, you may provide information that shows why you believe that the Medicaid Agency did not follow the rules in processing your request for services.

• Other FFS state fair hearing information:

  You may have an attorney represent you at the hearing. The attorney will be at your expense. If you hire an attorney, he or she must be licensed in Kansas.

  The most frequent mistake made by individuals during the process of preparing is failing to read the notices and documents issued as part of the state fair hearing process. The notices and documents will have deadlines. Read everything you receive very carefully.

• May I bring an attorney or other representative to the hearing?

  You may have an attorney represent you at the hearing. The attorney will be at your expense. If you hire an attorney, he or she must be licensed in Kansas. You may have a non-attorney represent  you at the hearing. If you want someone to represent you, you will need to fill out the medical representative authorization form.  That form may be found at the link below under Release of Information.  You will need to submit it with your state fair hearing request.

  https://www.kancare.ks.gov/policies-and-reports/kdhe-eligibility-policy/policy-appendix

  
  

  Two legal assistance organizations that may provide help with a state fair hearing at no or low cost are: 
  

  1. Kansas Legal Services
     Toll Free Phone: 1-800-723-6953 (application line)
     Website:  www.kansaslegalservices.org 
     

  2. Kansas Disability Rights Center
     Toll Free Phone:  1-877-776-1541
     Website:  www.drckansas.org