PHC California

Rachel Sakai
AHF Provider

State Hearing

You have the right to ask for a State Hearing within 120 calendar days from the date on PHC California’s letter about the results of your appeal (Notice of Appeal Resolution).

To request a State Hearing, contact:

California Department of Social Services
State Hearings Division
P.O. Box 944243, MS 9-17-37
Sacramento, CA 94244-2430
Tel (800) 952-5253; TTY users call (800) 952-8349
Fax (916) 651-5210 or (916) 651-2789

You or someone you appoint to represent you may request a State Hearing. A provider (with your written consent) may also request a State Hearing on your behalf.  The parties to a State Hearing include you, your representative or a representative of a deceased member and representatives from PHC California.

The State must reach a decision to a State Hearing within 90 calendar days from the date of the hearing request. In the case of expedited hearings, the State must reach its decision within three (3) working dates from the date of the request.

If the final resolution of the State Hearing is in your favor, PHC California will authorize or provide the disputed services as required with 72 hours from the date we receive notice from the State reversing our determination.

If the final resolution of the State Hearing is not in your favor, you may be liable for all costs accrued while the State Hearing was pending. PHC California may recover the cost of the disputed services furnished while the State Hearing was pending.

For more information about the appeals process, see Section 12 in the Membership Guide.

You will need the Adobe Acrobat Reader program to view the above forms. To download this free program click here or use the link above – the link will open a new window and take you to the Adobe website.

DHCS 030716 PHC Form 1.0