What is a grievance/appeal/state fair hearing?
A grievance is an expression of dissatisfaction about service issues, other than an action. A grievance shall not include alleged abuse, neglect, serious injury or death if a recipient when there is an apparent or suspected rights violation page 46 in the printed Member Handbook. A grievance, appeal, and state fair hearing are the steps that a Member may take to address problems. Grievances, appeals and state fair hearings and inquiries regarding the process can be directed to a KHS Ombudsman by calling 866-547-0222. An appeal is a request for a review of an action. An action is a decision that negatively impacts a Member’s ability to receive a service, or the amount of service wanted and when a Member wants it. It may also mean that KHS or its Provider Network did not make a decision about what services a member received, or did not provide the Member with authorized services within certain time frames. A State Fair Hearing is a State level review of member disagreements with Kansas H
