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Fair Hearing

You have a right to request a Fair Hearing with the DC Office of Administrative Hearings if you believe Medicaid was wrong in denying, reducing suspending, or stopping a service or item. You may call or make your request in writing to:

DC Office of Administrative Hearings 441 4th Street, NW, Suite 450 North Washington, DC 20001 Telephone Number:  202-442-9094

Your Rights

During the appeals (Fair Hearings and Reconsideration) and complaints/grievances processes:

  • You have the right to a Fair Hearing and may request a hearing no more than ninety (90) days from the postmark of the letter notifying you of the action taken by the DC Government and/or EPD Waiver providers
  • You have the right to keep receiving a benefit while your Fair Hearing is being reviewed. To keep your benefit during a Fair Hearing, you must request a Fair Hearing before the 30 day notice ends
  • You have the right to request a Reconsideration within 21 days of the date noted on the adverse notice (regarding LOC assessments)
  • You have the right to have someone from the DC Health Care Ombudsman help you through the grievance process
  • You have a right to represent yourself or be represented by your family caregiver, lawyer or other representative of your choice
  • You have a right to have accommodations made for any special healthcare needs you have
  • You have a right to TTY/TDD capabilities and services for the visually impaired;
  • You have a right to translation services and/or an interpreter; and
  • You have a right to see all documents related to your appeal (Fair Hearing or Reconsideration) or your complaint/grievance.