Denial of Services – Advocacy Update

Advocacy update! Know that resources and steps of action are available if you or a loved one are denied services. Note that if the individual is currently receiving the service that was denied for renewal, they are entitled to resume that service during the duration of the appeal process, so the authorization must be renewed while the appeal takes place until a final determination is made.

You can find the forms here.

1. Should an individual receive notice of denial of services, the provider can tell the individual to file a grievance.

2. With a Notice of Action (NOA), the individual can file a formal appeal with the MCO.

3. The last step is to request a state fair hearing if the appeal is unsuccessful.

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