Advocacy 101 - Challenging an Agency’s Denial or Reduction of Your Medicaid Services

Image of the Advocacy 101 e-booklet coverThis Disability Topic and the related e-booklet titled Advocacy 101 both explain the steps required to challenge a denial or reduction of a Medicaid State Plan or Medicaid Waiver service. Medicaid services are provided through the Medicaid State Plan and various home and community based services programs called Medicaid Waivers.

The tabs below are a condensed version for easy reference. If you would like more information, please download Advocacy 101, the comprehensive e-booklet from Disability Rights Florida.

Please also view our Advocacy 101 Webinar, available on our Webinars and Trainings page.

Notice & Appeal

As a person with disabilities, you have a legal right to both Notice of and Appeal from an agency decision to reduce or deny your Medicaid services.

These appeals occur in administrative hearings conducted by the Department of Children and Families’ Office of Appeals Hearings (OAH).

The person whose Medicaid services were reduced or denied is called the Petitioner.

The letter denying or reducing your services is called a Denial Notice and it is your guide to requesting a hearing. The Denial Notice should contain the reason for denial/reduction, specific services denied or reduced, how you can challenge this, the deadlines for doing so, and contact names and addresses.