Attention Medicaid Members

In January 2020, the federal government declared a public health emergency (PHE) in response to COVID-19. Under the PHE, the Texas Health and Human Services Commission (HHSC) provided certain flexibilities, including allowing Medicaid members more time to request a fair hearing. Instead of 120 days to request a fair hearing after an internal appeal, members were given up to 150 days to request a fair hearing with HHSC during the PHE. 

HHSC will be ending this flexibility on May 11, 2023.

Starting on May 12, 2023, if you receive a “Member Notice of Internal Appeal Decision” and want to appeal it, you must file your request for a fair hearing with or without an external medical review no less than 90 calendar days and no more than 120 calendar days from the date the notice is mailed. State fair hearing requests filed past this deadline may not be reviewed.

If you have any questions, please call Member Services at:

STAR/CHIP: 210-227-2347 (local) | 1-800-434-2347 (toll-free)
STAR Kids: 210-358-6403 (local) | 1-855-607-7827 (toll-free)

MORE INFORMATION

State Fair Hearings & External Medical Reviews

Beginning September 1, 2024 Community First Health Plans, Inc. will be adding STAR+PLUS to its line of health care products.

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