General eligibility requirements that apply to all Apple Health programs

Requesting an administrative hearing

Revised Date: 
December 29, 2011

Purpose: Fair Hearing WAC are found in chapter 182-526 WAC

Clarifying Information

  1. Either the individual or their authorized representative may request a hearing. The request must be made within in 90 days of the date of the decision. Decisions regarding the timeliness of a hearing request are the responsibility of the ALJ. All hearing requests should be forwarded for scheduling regardless of the date of the request. See RCW 74.09.741
  2. The request does not need to be in any particular form and can be made verbally or in writing.
  3. The request can be made to any responsible agency employee.
  4. The request should include the decision being appealed and why the individual is dissatisfied with the decision. However, any request indicating dissatisfaction with an agency decision should be treated as a hearing request.
  5. An individual may request a hearing several ways:
    1. Classic Washington Apple Health (Medicaid) decisions:
      1. In writing to:
        1. CSO of record (address is on the top left of any letter sent); or
        2. DSHS Customer Service Center, PO Box 11699, Tacoma WA 98411; or
        3. Office of Administrative Hearings, PO Box 42489, Olympia WA 98504; or
        4. DSHS fax 888-338-7410
      2. By phone:
        1. HCS office (phone number is on the top right of any letter sent); or
        2. DSHS Customer Service Contact Center at 877-501-2233; or
        3. Office of Administrative Hearings at 360-407-2700.
    2. In person at any HCS or CSO office.
      1. MAGI-based Washington Apple Health (Medicaid) decisions:
        1. In writing to:
          1. Health Care Authority, PO Box 45504, Olympia WA 98504; or
          2. WAHBE Appeals, PO Box 1757, Olympia WA 98507; or
          3. Office of Administrative Hearings, PO Box 42489, Olympia WA 98504; or
          4. HCA fax 866-720-2892; or
          5. WAHBE fax 855-867-4467
      2. By phone:
        1. Health Benefit Exchange (HBE) call center at 855-859-2512; or
        2. Health Care Authority at 800-562-3022; or
        3. Office of Administrative Hearings at 360-407-2700.

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