Instructions
Please be advised that in order to take advantage of the Office of Administrative Hearings e-filing system, all appellants and agency heads will need to sign and submit a consent form prior to usage.
Form
Instructions
Please be advised there are time limits or deadlines in which your appeal must be filed. Review the notice you received from DCF so you are aware of the deadline or deadlines in your particular case or cases.
While no specific form is required, below are copies of forms you may use. Be sure to:
- Print the form.
- Complete the form as best you can.
- Identify the specific action you are appealing and the DCF office that took the action you are appealing.
- Sign the form.
- Attach a copy of the notice from which you are appealing.
- Send to the Office of Administrative Hearings via U.S. mail or FAX (785) 296-4848.
Forms
Instructions
Please be advised there are time limits or deadlines in which your appeal must be filed. Review the notice you received from DCF so you are aware of the deadline or deadlines in your particular case or cases.
While no specific form is required, below are copies of forms you may use. Be sure to:
- Print the form.
- The "Provider request" form is only applicable for hearings sought by Medicaid service providers regarding the provider's Medicaid reimbursement. Prior to requesting any such fair hearing, Medicaid service providers must first satisfy all applicable contractual and regulatory review processes.
- Complete the form as best you can.
- Identify the specific action you are appealing and the state agency (DCF, KDADS, or KDHE) that took the action you are appealing.
- Sign the form.
- Attach a copy of the notice from which you are appealing.
- Send to the Office of Administrative Hearings via U.S. mail or FAX (785) 296-4848.
Forms
