OHCA Appeals Unit (not DHS Appeals Unit) is responsible for conducting hearings for ADvantage Waiver appeals – both financial appeals and medical appeals.
OHCA will accept either of the following forms:
- Request for a Fair Hearing. H-1 (13MP001E English / 13MP001S Spanish).
- Member Appeal Form. LD-1. Member Resources – Forms and Instructions, Guides and Manuals
The member, client, friend or authorized representative may call OHCA (405-522-7217) or email email@example.com to obtain an LD-1 (Member Appeal Form).
If DHS (Caseworker/Nurse/Appeals Unit) receives an ADvantage appeal (or assists them in completing the appeal), he or she lists “ADvantage Waiver Hearing” in the Subject line and forwards it, via email to firstname.lastname@example.org.
Staff will receive notice of appeal, OHCA’s request for documents, and the names and contact information for the OHCA Attorney and paralegal assigned to the appeal from HR&MS staff.
AFS caseworker will submit the completed DHS Form 13MP002E (Hearing Summary / H-1-A) to the OHCA paralegal within two weeks from the date he/she receives the notification of the appeal and requested documents. If the DHS caseworker is unable to provide the completed Hearing Summary within two weeks of notification, he/she will notify the OHCA paralegal.
Questions from the OHCA attorney or paralegal are directed to DHS in preparation for the hearing. OHCA attorney or paralegal notifies the DHS caseworker and supervisor of the hearing date as soon as it is scheduled.
Hearings will either be virtual, by phone or in person. All relevant DHS staff are required to participate.