How to appeal a MassHealth decision
As a MassHealth applicant or member, if you disagree with a MassHealth decision, or if we modify or deny a prior authorization (PA), you have a right to appeal the decision.
You will need to fill out the Fair Hearing Request form within the timeframes listed on the form. Please be sure to read the form before completing.
After you submit your appeal, the Board of Hearings will send you a notice of your hearing date, time, and place at least 10 calendar days before your scheduled hearing date.
At the hearing, you may represent yourself or be represented by a lawyer or other representative at your own expense. You may contact a local legal service or community agency to get advice or representation at no cost. To get information about legal service or community agencies, call the MassHealth Customer Service Center.
If you cannot come to the hearing for good cause, or if you need a telephone hearing, you must call the Office of Medicaid, Board of Hearings before the hearing date.
- Main: (617) 847-1200
- Toll free: (800) 655-0338
Here is the link to the MassHealth Fair Hearing Request: https://www.mass.gov/doc/fair-hearing-request-form-2/download Fax the form to the Office of Medicaid, Board of Hearings at (617) 847-1204. Alternatively, send a copy to the Office of Medicaid, Board of Hearings at:
100 Hancock St.
6th Floor
Quincy, MA 02171