Glossary
State fair hearing
In one sentence
A hearing in front of the state rather than the plan. Federal rules cap the filing window at 90 days from the date the notice of action was mailed, and states are free to allow less.
Also written as Fair hearing, Administrative hearing.
What state fair hearing actually means
This is the proceeding most people picture when they say they are appealing to the state. It is governed by its own subpart of the federal Medicaid rules, and two features of it are worth knowing before you file.
The first is the window. The federal rule sets an outer limit rather than a deadline: the state must allow a reasonable time, and it may not stretch past 90 days from the mailing date of the notice. Several states have set shorter windows, and where they have, the shorter one is the one that binds you. The number printed on your own notice is the number to work to.
The second is what the hearing is. It starts over from the beginning rather than reviewing the earlier decision for error, and evidence gets presented. That is a more open proceeding than the word "appeal" usually suggests.
The text it comes from
This is the wording the definition rests on. Where it decides anything for you, read the section rather than our summary of it.
The federal ceiling is 90 days and it runs from mailing, not from receipt: the agency "must allow the applicant or beneficiary a reasonable time, not to exceed 90 days from the date that notice of action is mailed, to request a hearings." The wording, including the typographical error at the end, is the regulation's own.
42 CFR §431.221(d), Electronic Code of Federal Regulations, effective August 2026 · source
The hearing starts over rather than reviewing the file for error. The rules define a "De novo hearing" as "a hearing that starts over from the beginning" and an "Evidentiary hearing" as "a hearing conducted so that evidence may be presented."
42 CFR §431.201, Electronic Code of Federal Regulations, effective August 2026 · source
Where this comes from
- 42 CFR §431.221(d), Electronic Code of Federal Regulations, effective August 2026 — www.ecfr.gov/current/title-42/part-431/section-431.221
- 42 CFR §431.201, Electronic Code of Federal Regulations, effective August 2026 — www.ecfr.gov/current/title-42/part-431/section-431.201
Where this comes up
- Notice of action
- Continuation of benefits
- How a Medicaid fair hearing works
- Appeal deadline calculator
- Every term we have defined
American GLP is not a law firm, an insurer, a government office or a clinician, and nothing here is legal or medical advice. This page says what a published rule means by a word. Which rulebook governs you depends on your plan, and your own notice and plan documents govern your case.