Fair and Fraud Hearings Frequently Asked Questions

If you have received a Notice of Hearing for your appeal, the contact information is at the top of the page. If you haven't received a notice, contact the main Appeals Division at 512-231-5701. Appeals are heard by hearing officers across the state.

If you've received notice of reducing, interrupting or ending your services or benefits, instructions for requesting an appeal are included on the notice. If you haven't received a notice, contact your caseworker, service coordinator with your managed care organization (MCO), or the local Texas Health and Human Services office in your area. An appeal may be requested in person or by phone or mail, but sometimes you'll need a written appeal request. You also may appeal if the agency fails to take action on a request for services in reasonable time.

You'll receive a Notice of Hearing in the mail from the hearing officer assigned to your appeal. The notice will state the date, time and location of the hearing. Most hearings are held by phone and, in most cases, you must call into a conference line. The call-in information will be included in the notice.

Yes. The agency representative must send a copy of the documents to be used at your hearing to both you and the hearing officer before the hearing. If your hearing is a week away or less and you haven't received the agency's documents, call the Appeals Division at 512-231-5701.

Hearing officers must not take longer than 90 days (60 days for SNAP food benefits) from the date of the appeal request to issue a decision. In some cases, it could take more time to issue a decision because of rescheduling or other delays in the hearing process.

You may ask for an administrative review within 30 days of the decision date. After reviewing all evidence and the hearing officer's decision, a Texas Health and Human Services attorney will issue a decision.

During a review of the case, program staff may find an error and correct it before the hearing date. You'll be notified of the correction. If it resolves the issue on appeal, withdraw your appeal request by contacting the Appeals Division at 512-231-5701.

If you provide extra information you haven't provided before, you should receive a notice in response. If your case wasn't approved, you usually have the right to reapply and have your situation considered while waiting for the fair hearing. This doesn't affect the outcome of the fair hearing.

Most pre-hearing conferences are used to clarify important information about the case or if the hearing officer has the authority to conduct the hearing. If you feel a pre-hearing conference is needed, contact the hearing officer. They may schedule a pre-hearing conference if it's necessary to resolve any issues before the hearing.

You aren't required to send any information, but if you have any documents that you would like the hearing officer to consider, you may send them to the hearing officer before the hearing. You can find the hearing officer's fax and mailing address on the Notice of Hearing.

You can review the documents the agency representative will use at the hearing to gather questions and point out any errors you may have found. If you have any documents that will help your argument, send them to the hearing officer before the hearing.

You should let the hearing officer know you'll need assistance before the hearing.

No. HHS will provide an approved interpreter for your fair hearing, if needed. Contact the hearing officer before the hearing to ask for an interpreter.

The hearing officer may not speak to either party about the facts of the case before the hearing. They can only discuss procedural issues such as scheduling and any accommodations needed for the hearing. This ensures a fair and unbiased hearing for all of those involved.

The cover letter sent with the hearing decision includes a phone number you can call if you don't understand the decision. You can also call the Appeals Division at 512-231-5701. Someone from the Appeals Division can go over the decision with you.

Yes. You may apply for benefits at any time. You don't have to wait for your hearing or a hearing decision.

Depending on the program and when you ask for an appeal, you may be able to receive continued benefits while you wait for outcome of the appeal.

The agency may ask you to pay back the money spent on your continued benefits if the hearing officer upholds the action taken by the agency.

Yes. You have the right to ask someone to represent you at the hearing and to help you state your case. You also may invite other people who could provide more facts to be witnesses.

You have 90 days from the date of the denial notice to request a fair hearing. If the agency that acted on your case is a managed care organization, you have 120 days to ask for a fair hearing from the date their internal appeal ended.

You may ask for an appeal after the 90-day time frame, but you'll need to tell the hearing officer why you missed the deadline. The hearing officer will decide if you had good cause for not submitting the appeal on time. Good cause means something out of your control caused you to miss the hearing.

If you can not attend the hearing on the date and time stated on the Notice of Hearing, please contact the hearing office prior to your hearing date. You can call the hearing office at the phone number listed at the top of the Notice of Hearing and request a reschedule. Or you can send a written request to the hearing officer using the form provided with your Notice of Hearing.

If the hearing officer finds good cause, your appeal will be reopened and rescheduled. If they don't find good cause, the dismissal of your appeal request will stand, and an HHS attorney will review the hearing officer's determination of good cause to confirm policy was followed.

No. You don't have to attend in person unless you have a face-to-face hearing. Most hearings are held by phone. The hearing date, time and call-in number are included in the Notice of Hearing.

If you can not attend the hearing on the date and time stated on the Notice of Hearing, please contact the hearing office prior to your hearing date. You can call the hearing office at the phone number listed at the top of the Notice of Hearing and request a reschedule. Or you can send a written request to the hearing officer using the form provided with your Notice of Hearing.

You may mail the information to the hearing officer at the address listed on the Notice of Hearing. If the hearing officer decides the facts are relevant to the case, the information will be shared, and the hearing may be continued.

Once everyone is present, the hearing officer will open the hearing record and put everyone under oath. The hearing officer will confirm the action on appeal and the dates of the action. Documents will be submitted into the hearing record and the agency will begin their testimony about the action on appeal.

After the agency has testified, you'll be able to ask questions about the agency's testimony. Once questioning ends, you'll have the chance to give your own testimony. The hearing officer may ask questions to get all the facts needed to make a decision on the appeal.

Hearing officers hear appeals for programs administered by HHS agencies, including SNAP food benefits, Temporary Assistance for Needy Families and services funded by Medicaid.

The hearing officer is required by state and federal law to be impartial and have no previous knowledge of the case. In order to remove any conflict of interest, hearing officers don't work for the same division within the agency that took the action.

The same issue or agency action can only be appealed once, which starts the fair hearing process. If you disagree with the hearing officer's decision, you may ask for an administrative review. If you disagree with the outcome of the administrative review, you may ask for a judicial review by filing with the district courts in Travis County.

The length of the hearing depends on the type of issue on appeal and how complex the issue is. You should plan on at least one hour. If the hearing is expected to last longer, you will be notified during the hearing.

No. You don't need to have an attorney, but you may have an attorney represent you at the hearing at your own expense. For free legal help, contact your local legal aid office listed on your Notice of Hearing.

Yes. You may record the hearing. But the official record of the hearing is the recording made by the hearing officer.

The hearing officer will send a copy of the hearing recording for free if asked.

A copy of the documents used to make the decision will be sent to you before the hearing. To get a copy of your entire case file, contact your caseworker, your caseworker's supervisor, the ombudsman's office or the hearing officer.

Yes. Program staff may work on any new actions such as processing a new application or a reported change.

Yes. You can appeal a notice of overpayment.