Eligibility State Fair Hearings

The eligibility state fair hearing is processed by the Office of Administrative Hearings (OAH). It is an opportunity for the applicant/member to speak about the eligibility decision made by the Medicaid agency. Eligibility state fair hearings include the opportunity to speak about the HCBS waiver eligibility decision made by the Department on Aging and Disability (KDADS). The member and either the Medicaid agency or KDADS 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 or by you and KDADS at the hearing. An eligibility state fair hearing can be requested regarding any negative eligibility decision or if the application process is delayed.

State Fair Hearing Forms

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Eligibility State Fair Hearings

What is an eligibility state fair hearing?

An eligibility state fair hearing can be requested regarding any eligibility decision made by the Medicaid agency or if the application process is delayed. The eligibility state fair hearing is processed by the Office of Administrative Hearings (OAH) with the State of Kansas. It is similar to a trial in court with witnesses and exhibits. It is an opportunity for the applicant/member and the Medicaid agency to speak to an impartial Administrative Law Judge about the eligibility decision made by the Medicaid agency. The OAH judge conducts the hearing. The judge does not represent you or the Medicaid agency. He or she will make a decision based upon what is presented by you and the Medicaid agency at the hearing. OAH will send a notice of hearing with the date and time of the hearing at least 10 days before the hearing. The hearing is recorded. The recording will become part of the official record of your case. Hearings are conducted by telephone and also at OAH.
May I review the information relied upon by the Medicaid agency in making the decision about my eligibility?

Yes. You or your representative may review the information prior to the hearing date.
How do I submit a state fair hearing request regarding an eligibility decision?
The applicant, member or their authorized representative’s state fair hearing request may be submitted by telephone or in writing.
- Eligibility State fair hearing request form
- To submit an eligibility state fair hearing request by telephone call:
- Call Center Phone Number: 1-800-792-4884
- TDD/TTY Phone Number: 1-800-792-4292
- The call center staff will complete the state fair hearing request form for you if your request is made by telephone.
- To submit an eligibility state fair hearing request by fax send to:
- (785) 296-4848 (Requests greater than 20 pages cannot be faxed).
- To submit an eligibility state fair hearing request by mail send to:
- Office of Administrative Hearings
- 1020 S. Kansas Ave.
- Topeka, KS 66612
To submit a Withdrawal go to:
Withdrawal of State Fair Hearing Request
Is there a deadline for filing an eligibility state fair hearing?

Yes, the eligibility state fair hearing request must be filed within 33 calendar days from the date on the notice regarding your eligibility.
Can my coverage be continued until the hearing decision?

Your coverage will be continued if you ask for a hearing either before the effective date of the eligibility decision or within 15 calendar days from the date of the notice, whichever is later.
What is the process once an eligibility state fair hearing request has been submitted?

The Medicaid agency or KDADS will submit documents related to the eligibility decision 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 your eligibility 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 or KDADS 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 with my request for a fair hearing?

At the time you request the fair hearing and also prior to the fair hearing, you may provide information that shows why you believe that the state or state worker did not follow the rules in processing your application or renewal.
What will I need for my eligibility state fair hearing?

The Medicaid agency will send you an agency summary. It outlines the facts of your case. You will need the agency summary during the hearing.
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
May I have witnesses at the hearing?

Yes. You may have witnesses testify on your behalf at the hearing. If you need a subpoena issued that requires the subpoenaed person to participate in the hearing, you must ask the judge in writing to issue a subpoena for that person. You must ask the judge at least seven days before the hearing. You will be responsible for giving the subpoena to the witness. You will also be responsible for paying for any costs associated with the witness participating in the hearing.
If I don’t like the judge’s decision, what is the next step?

You may ask the State Appeals Committee to review the judge’s decision. You must send your request in writing addressed to the State Appeals Committee. Your request should be mailed to the address in the judge’s decision. You must ask for the review by the State Appeals Committee within 18 days of the judge’s decision of the judge mailed the decision to you. You must ask for the review within 15 days if the judge sent the decision to you electronically. There will not be another hearing. The State Appeals Committee will review the judge’s decision and issue a decision.
If I don’t like the State Appeal Committee’s decision, what is the next step?

You may file a Petition for Review with the district court. You must file the district court Petition in the county where the decision was issued.
How do I withdraw my request for a state fair hearing?

The form for withdrawing a request for a fair hearing can be found here. The completed form can be faxed to (785)-296-4848.
Withdrawal of State Fair Hearing Request
Other eligibility state fair hearing information

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.