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Dealing with Denials or Reductions of Medicaid Services

I’ve heard from my child’s service provider that my child’s Medicaid services are being denied or reduced. Am I supposed to get something in writing from my child’s Medicaid managed care organization (MCO) about this?

Yes, according to state and federal Medicaid law the MCO (managed care organization) must send a written notice of a denial or reduction in services to you and your child.

I’ve received a denial letter in the mail from the MCO about a denial or reduction in my child’s services. Do I have the right to challenge the MCO’s denial or reduction decision?

Yes, you have the right to challenge the MCO’s decision to deny or reduce your child’s services. You can request an appeal or a Medicaid fair hearing.

Click the link below for the full pdf version of "Dealing with Denials or Reductions of Medicaid Services: Frequently Asked Questions" by Disability Rights Texas.