The Online Resource for Massachusetts Poverty Law Advocates

Request for Fair Hearing Form

Date: 
06/06/2016
Author: 
EOHHS

Fair Hearing Request Form [FHR-1 (09/10)]

A form used by applicants and members who want to ask for a fair hearing.

How to Ask for a Fair Hearing/Fair Hearing Request Form [FHR/MCO-PCCBH-SCO (09/10)]

A form used by members who want to ask for a fair hearing and are enrolled in a managed care plan, managed care organization, the Primary Care Clinician (PCC) Plan's Behavioral Health Program, or a Senior Care Organization.


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