Medicaid Due Process

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Medicaid Due Process Angela Davis March 28, 2022

Medicaid Due Process

Hamilton County DD Services (HCDDS) shall provide written notice at least 15 calendar days in advance of any action that involves a reduction, suspension or termination of a Medicaid service or item that is being provided. A written notice will also be provided when a request for a Medicaid service or item is denied at the time of the denial. Advance notice will also be provided when a Medicaid service is being approved.

To appeal a Medicaid decision:

  • Within 90 days of a denial or proposed action, the individual, parent of a minor or guardian will notify the Ohio Department of Job and Family Services (ODJFS) of their request to formally appeal.
  • The request to appeal can occur by mailing the notice that was received by HCDDS to the Ohio Department of Job and Family Services, Bureau of State Hearings, P.O. Box 182825, Columbus, Ohio 43218-2825 or by emailing the notice to bsh@jfs.ohio.gov.
  • Services will not be reduced, suspended, or terminated until the appeal process is completed when the request is received on or before the effective date of the proposed action.
  • In order to attempt to resolve the issue prior to a hearing, a county conference can be requested with HCDDS before or after a hearing has been formally requested with ODJFS.