State Fair Hearings
Asking for a State Fair Hearing with Department of Health and Hospitals (DHH)
A State Fair Hearing with the Division of Administrative Law (DAL) is not a part of AmeriHealth Caritas Louisiana in any way. AmeriHealth Caritas Louisiana must follow the hearing decision.
You will not lose your AmeriHealth Caritas Louisiana membership or health care benefits if you file an appeal or ask for a State Fair Hearing with DHH.
You may request a State Fair Hearing if:
- You do not agree with an AmeriHealth Caritas Louisiana decision
You may ask for a State Fair Hearing with the DAL within thirty (30) days from the date of AmeriHealth Caritas Louisiana’s appeal determination. You must complete AmeriHealth Caritas Louisiana’s appeal process prior to requesting a State Fair Hearing with the DAL.
- You want to Leave AmeriHealth Caritas Louisiana
You may ask for a State Fair Hearing with DHH if you want to leave AmeriHealth Caritas Louisiana. The request for the State Fair Hearing may be filed at any time.
You may request a State Fair Hearing by mail, phone, fax, or online. You have 30 calendar days from the date of AmeriHealth Caritas Louisiana’s appeal determination letter to make this request. In a State Fair Hearing, the DAL has final authority to determine whether services must be provided.
Ways to appeal
- By mail: Division of Administrative Law Health and Hospitals Section
Post Office Box 4189
Baton Rouge, LA 70821-4189
- By fax: 1-225-219-9823
- By phone: 1-225-342-5800
- Fill out the appeal request form online
An authorized representative or network provider, acting on your behalf and with your written consent, may request a State Fair Hearing once AmeriHealth Caritas Louisiana’s appeals process has been exhausted.
You have the right to continue benefits while a State Fair Hearing is pending. You may call AmeriHealth Caritas Louisiana and ask that your benefits continue. The toll-free number is 1-888-756-0004. You must ask for this within 10 calendar days from the certified mail date of AmeriHealth Caritas Louisiana’s appeal determination letter.
Please note that you may have to pay the costs of these services. This could happen if the DAL's State Fair Hearing decision agrees with the denial by AmeriHealth Caritas Louisiana.