District of Columbia Medicaid fair hearing and continuation routes

What changed

DHCF's Fair Hearing page says beneficiaries have a right to request a Fair Hearing with the DC Office of Administrative Hearings if Medicaid was wrong in denying, reducing, suspending, or stopping a service or item. The page says a hearing may be requested no more than ninety days from the postmark of the adverse letter, continuation of benefits requires requesting the Fair Hearing before the 30-day notice ends, reconsideration may be requested within 21 days for level-of-care assessments, and a beneficiary may be represented by a family caregiver, lawyer, or other representative. DHCF's Medicaid page separately points SSI-linked Medicaid eligibility hearings to the Social Security Administration, and the DC Medicaid State Plan Section 4 indexes hearings for applicants and recipients.

Why it matters

Caregivers often need to preserve services while a denial, reduction, suspension, or termination is reviewed. This row anchors the DC Benefits & Coverage enforcement path without converting it into case-specific legal advice.

Who it touches

Family caregivers, People receiving care, Businesses and agencies that must complyDC Medicaid beneficiaries, EPD Waiver participants, family caregivers, authorized representatives, SSI-related Medicaid applicants, health care ombudsman users

What it does

Gives people a right or protection

Topics

Keeping Medicaid coverage

• DHCF Fair Hearing
• DHCF Medicaid
• DHCF Medicaid State Plan Section 4, General Program Administration

Last reviewed Jul 4, 2026. This is information, not legal advice; check the source for the current text.