![]() ![]() ![]() The hearings officer’s contact information will be located on the Notice of Hearing. The packet will contain policy excerpts and documents that the agency used for the action on appeal. Once the hearing is scheduled, the agency representative or MCO representative will mail a packet with the information that will be presented in the hearing as evidence. Hearing participants call into the hearing, and the hearings officer will allow enough time for all parties to submit evidence and provide testimony regarding the issue on appeal. FFH will mail a Notice of Hearing to the hearing participants with the date and time of the hearing, a toll-free number and an access code. ![]() Prepare for Your Hearingįair and fraud hearings are typically conducted by conference call. If the issue relates to your managed care organization services, contact your MCO service coordinator. The fair hearing process begins with asking for an appeal, which can be requested for many of the actions or inactions that happen to SNAP, TANF, Medicaid, or other state-issued benefits or services.Īn appeal request can be made in writing, by calling 2-1-1 or by visiting a local HHSC office. If an alleged violation is found, the OIG will send a referral to FFH for an Administrative Disqualification Hearing.Īccess the FFH archive for past decisions here.Ĭlick here to contact FFH. The Office of Inspector General (OIG) is responsible for investigating intentional program violations. In 2022, the office received 30,191 appeals and issued 29,532 decisions.įraud hearings are conducted for two programs: SNAP and TANF. HHSC Fair and Fraud Hearings currently has 49 staff members. The Fair and Fraud Hearings Handbook provides guidance on the appeal process for applicants, clients, client representatives, program representatives and hearings officers. Hearings officers conduct hearings, consider evidence and issue decisions in accordance with rules, regulations, and state and federal law. Appeal requests submitted after the 90 or 120 day time frames will be reviewed for good cause for an untimely appeal and whether the fair hearing will be held. Most appeal requests must be made within 90 days, or 120 days for managed care organizations (MCOs), from either the date of the case action or the effective date on the Notice of Case Action. This notice will describe the action and the reason the agency took the action. When state-issued benefits or services are issued, ended, interrupted, denied or reduced, you will receive a Notice of Case Action. These programs include the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), all Medicaid-funded services, and other programs that are required by state or federal law or rules to provide the right to a fair hearing.įair hearing activities are based on federal and state statutes, rules and regulations. The Texas Health and Human Services Commission (HHSC) Fair and Fraud Hearings Department (FFH) receives appeal requests from applicants and clients contesting decisions concerning benefits and services of several programs. ![]()
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