Fee-for-service and managed care fair hearing timelines

During the COVID-19 PHE, fee-for-service (FFS) members have had 120 days to request a fair hearing for eligibility or FFS appeals.  Managed care members have been able to request a fair hearing without exhausting the managed care entity's grievance and appeal process and have had 240 days to request a fair hearing.

Effective May 12, 2023, FFS fair hearing requests must be received no later than 33 calendar days following the effective date of the action being appealed or the date of the notice of agency outlined in Indiana Administrative Code 405 IAC 1.1-1-3.  Managed care members will have to exhaust the managed care entity's grievance and appeals process before requesting a fair hearing and will have 120 calendar days to request a fair hearing.