An official State of Texas website.
Revision 15-4; Effective October 1, 2015
All Programs
All fair hearing requests are processed in the State Portal. The local office staff (including Customer Care Center [CCC] staff) and Centralized Representation Unit (CRU) staff have separate responsibilities and must follow the following procedures when processing fair hearing requests and appeals.
B—1031 Local Office Procedures for Hearing Requests
Revision 15-4; Effective October 1, 2015
When any member of a household or the household's representative expresses dissatisfaction with a decision regarding benefits or services, the local office staff takes the following actions:
- Review the Eligibility Determination Group (EDG) to determine accuracy of the action;
- Take action to correct any agency error that results in an increase in benefits;
- Clearly document any discovered error and the action taken to correct the error;
- Explain the basis for the decision and the applicable policies to the individual;
- Provide the individual an opportunity to have a conference with the supervisor (including a conference within two workdays for an individual who wants to contest an expedited services decision); and
- Provide the individual an opportunity to request a fair hearing.
The same day a fair hearing request is received:
- in person, over the telephone or in writing — the advisor/supervisor enters the fair hearing request with the Add New Appeal tab in the State Portal Appeals/RFR (Request for Revision). These entries automatically create an Appeal Request for (Program/TOA) for CRU staff.
- by fax or mail — the advisor/supervisor faxes or mails the appeal using the fair hearing cover sheet to the expedited fax line (1-866-559-9628) for processing. The advisor must not:
- complete and submit Form H4800, Fair Hearing Request Summary;
- enter the fair hearing request in State Portal; or
- enter the fair hearing request through left navigation in the Texas Integrated Eligibility Redesign System (TIERS).
- advisors must consult with the supervisor if the individual requests information staff considers confidential.
B—1031.1 Office of Attorney General (OAG) Child Support Division Region Contacts
Revision 15-4; Effective October 1, 2015
| OAG Region | Primary Contact | Secondary Contact | Physical Mailing and Centralized Email Addresses |
|---|---|---|---|
| 1 Lubbock |
Angelia Gregg 806-761-4715 Fax: 806-763-7579 |
Renee DeLaRosa 806-761-4704 Fax: 806-763-7579 |
4630 50th Street, Ste 500 Lubbock, TX 79414-3521 OAGarea1.FairHearing@texasattorneygeneral.gov |
| 2 San Antonio |
Vanessa Vasquez 210-804-6488 Fax: 210-930-3625 |
Martin Martinez 210-804-6489 Fax: 210-930-3625 |
3460 Northeast Parkway San Antonio, TX 78218-3304 OAGarea2.FairHearing@texasattorneygeneral.gov |
| 3 McAllen |
Anna Rangel 956-926-4524 Fax: 956-631-2451 |
Vacant | 3331 N. McColl Road McAllen, TX 78501-5536 OAGarea3.FairHearing@texasattorneygeneral.gov |
| 4 Dallas |
Nancy Hernandez 214-915-3721 Fax: 214-915-3750 |
Oscar Sanchez 214-915-3720 Fax: 214-915-3750 |
400 South Zang Blvd. Ste. 1100 Dallas, TX 75208-6646 OAGarea4.FairHearing@texasattorneygeneral.gov |
| 5 Tyler |
Christy Cates 903-533-4005 Fax: 903-592-5732 |
Glen Elliott 903-533-4009 Fax: 903-592-5732 |
200 N. Broadway Avenue, Ste 355 Tyler, TX 75702-5747 OAGarea5.FairHearing@texasattorneygeneral.gov |
| 6 Houston |
Mark Jones 713-948-7673 Fax: 713-910-4806 |
Melissa Jimenez 713-787-7146 Fax: 713-789-7665 |
8866 Gulf Freeway, Ste 200 Houston, TX 77017-6529 OAGarea6.FairHearing@texasattorneygeneral.gov |
| 7 Austin |
Patricia Roark 512-358-3242 Fax: 512-892-8967 |
Annette Hernandez 512-358-3249 Fax: 512-892-8967 |
2512 S IH 35 Ste 200 Austin, TX 78704-5751 OAGarea7.FairHearing@texasattorneygeneral.gov |
| 8 El Paso |
Lorraine Sanchez-Rayas 915-782-4211 Fax: 915-782-4276 |
Barbara Ramirez 915-782-4236 Fax: 915-782-4276 |
6090 Surety Dr., Ste 250 El Paso, TX 79905-2062 OAGarea8.FairHearing@texasattorneygeneral.gov |
| 9 Ft. Worth |
Elizabeth House 817-834-7048 Fax: 817-834-7066 |
Kelly Robison 817-834-7038 Fax: 817-834-7066 |
2001 Beach St. Ste 700 Ft. Worth, TX 76103 Regional email not yet established |
OAG – Counties Served by Each Area
| Region | Counties Served |
|---|---|
| 1 Lubbock |
Archer, Armstrong, Bailey, Baylor, Briscoe, Brown, Callahan, Carson, Castro, Childress, Clay, Cochran, Coke, Coleman, Collingsworth, Comanche, Concho, Cottle, Crockett, Crosby, Dallam, Dawson, Deaf Smith, Dickens, Donley, Eastland, Fisher, Floyd, Foard, Gaines, Garza, Grey, Hale, Hall, Hansford, Hardeman, Hartley, Haskell, Hemphill, Hockley, Hutchinson, Irion, Jack, Jones, Kent, Kimble, King, Knox, Lamb, Lipscomb, Lubbock, Lynn, Mason, McCulloch, Menard, Mitchell, Montague, Moore, Motley, Nolen, Ochiltree, Oldham, Parmer, Potter, Randall, Reagan, Roberts, Runnels, Schleicher, Scurry, Shackelford, Sherman, Stephens, Sterling, Stonewall, Sutton, Swisher, Taylor, Terry, Throckmorton, Tom Green, Wheeler, Wichita, Wilbarger, Yoakum, Young |
| 2 San Antonio |
Atascosa, Bandera, Bexar, Comal, Dewitt, Dimmit, Edwards, Frio, Gillespie, Gonzales, Guadalupe, Karnes, Kendall, Kerr, Kinney, LaSalle, Maverick, McMullen, Medina, Real, Uvalde, Val Verde, Wilson, Zavala |
| 3 McAllen |
Brooks, Cameron, Duval, Hidalgo, Jim Hogg, Jim Wells, Kenedy, Kleberg, Nueces, Starr, Webb, Zapata |
| 4 Dallas |
Collin, Cooke, Dallas, Denton, Ellis, Erath, Hood, Johnson, Kaufman, Navarro, Palo Pinto, Parker, Rockwall, Somerville, Tarrant |
| 5 Tyler |
Anderson, Angelina, Bowie, Camp, Cass, Chambers, Cherokee, Delta, Fannin, Grayson, Gregg, Hardin, Harrison, Henderson, Hopkins, Houston, Hunt, Jasper, Jefferson, Lamar, Liberty, Marion, Morris, Nacogdoches, Newton, Orange, Panola, Polk, Rains, Red River, Rusk, Sabine, San Augustine, San Jacinto, Shelby, Smith, Titus, Trinity, Tyler, Upshur, Van Zandt, Wood |
| 6 Houston |
Austin, Brazoria, Ft Bend, Galveston, Harris, Matagorda, Montgomery, Waller, Wharton |
| 7 Austin |
Aransas, Bastrop, Bee, Bell, Blanco, Bosque, Brazos, Burleson, Burnett, Caldwell, Calhoun, Colorado, Coryell, Falls, Fayette, Freestone, Goliad, Grimes, Hamilton, Hays, Hill, Jackson, Lampasas, Lavaca, Lee, Leon, Limestone, Live Oak, Llano, Madison, McLennan, Milam, Mills, Refugio, Robertson, San Patricio, San Saba, Travis, Victoria, Walker, Washington, Williamson |
| 8 El Paso |
Andrews, Borden, Brewster, Crane, Culberson, East El Paso, Ector, Glasscock, Howard, Hudspeth, Jeff Davis, Loving, Martin, Midland, Pecos, Presidio, Reeves, Terrell, Upton, Ward, Winkler |
B—1031.2 Providing Form H4800-A, Fair Hearing Request Summary (Addendum), to Hearings Division
Revision 17-1; Effective January 1, 2017
Form H4800-A, Fair Hearing Request Summary (Addendum), provides a method to send documents or evidence used in a hearing that were not sent with the original submission and to report changes of address or other corrections to the appropriate hearings officer.
B—1032 Centralized Representation Unit (CRU)
Revision 15-4; Effective October 1, 2015
The CRU is a staff unit within Eligibility Services Support (ESS) that represents HHSC in fair hearings and implements hearing officers' decisions.
B—1032.1 Centralized Representation Unit (CRU) Staff Responsibilities
Revision 15-4; Effective October 1, 2015
CRU staff completes the following actions:
- claim the Appeal Request for (Program/TOA) task from the Task List Manager (TLM) Global Queue;
- review the EDG to determine if any correction is needed and take appropriate action;
- prepare the evidence packet and mail to the Document Processing Center (DPC) for imaging;
- ensure the hearing procedures are explained in a language the individual understands;
- mail a copy of the evidence packet to the individual, legal representative, authorized representative and any other witnesses participating in the hearing;
- create and send a fair hearing request in TIERS;
- enter in TIERS any necessary accommodations; and
- mark the task as Task Completed.
Once the fair hearings request has been scheduled by Hearings Division staff, a Fair Hearing Appointment for a (Program) Case task will be routed to the Fair Hearings Centralized Representation Unit TLM Global Queue.
CRU will:
- assign an agency representative for each hearing;
- attend the fair hearing as the agency representative; and
- present the agency's case by explaining the action being appealed, the documents submitted and how the agency policy applies to the issue(s) on appeal.
B—1033 Appeals Related to Decisions/Actions of an Electronic Benefit Transfer (EBT) Vendor
Revision 14-2; Effective April 1, 2014
All Programs
When an EBT vendor cannot resolve an account balance dispute or error resolution related to benefits to an individual's satisfaction, the vendor refers the individual to Lone Star Business Services (LSBS) for a second review. The individual may contact LSBS staff to request a fair hearing if still not satisfied with the results of the second review. CRU processes the appeal following the policy and procedures outlined in this section.
B—1034 Appeals Related to Services for Medicaid Recipients
Revision 15-4; Effective October 1, 2015
All Programs
The Texas Department of State Health Services (DSHS) handles appeals concerning specific services for Medicaid recipients including:
- lock-in;
- medical necessity for prior authorization of services; and
- denial, termination, suspension or reduction of covered services, or payment for services rendered.
For individuals who want to appeal service-related issues, staff must refer them to DSHS. DSHS individual notification letters include an address and telephone number for requesting appeals. Individuals who do not have a notification letter should be referred to the Medicaid Hotline at 1-800-252-8263.
Note: DSHS does not allow individuals to appeal decisions made by the Health Insurance Premium Payment (HIPP) program. To obtain assistance in resolving problems or issues with the HIPP contractor:
- individuals must contact the Medicaid Hotline at 1-800-252-8263.
- staff must contact the Third-Party Resource (TPR) Unit at 1-800-846-7307.
B—1035 Appeals Related to Accounts Receivable Tracking System (ARTS)
Revision 15-4; Effective October 1, 2015
All Programs
For all individual requests for appeals related to ARTS collection notices, the advisor must make the following entries on Form H4800, Fair Hearing Request Summary:
- In the From box, if the appeal is regarding a:
- Claims Investigation (CI) collection notice, enter the CI unit supervisor, mail code, and phone number.
- Treasury Offset Program (TOP) collection notice, enter ARTS Hearing Representative, 512-406-3800, at mail code E-411.
Note: If the individual does not know if the collection notice is a result of a CI claim or TOP, enter the CI unit supervisor.
- In Section 1, Program, check the appropriate program box.
- In Section 2, Agency Action Resulting in a Hearing Request, check D, Not Benefit Amount Related. This will indicate to the hearing officer that the appeal does not affect current benefits.
- In Section 8, Summary of Agency Action and Applicable Handbook Reference(s) or Rules, enter the following message: "Collection Notice - Overpayment Claim" (See B-700, Claims).
The advisor must notify the appropriate Claims Investigations Unit supervisor and ARTS supervisor of the hearing request. The advisor sends a copy of Form H4800 to the local Claims Investigation Unit supervisor or the ARTS supervisor, as appropriate, and faxes a copy of Form H4800 to ARTS at 512-438-3061.