File an Appeal

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Applicants or recipients of Medicaid who are dissatisfied with a decision made by the county agency or the North Dakota Department of Human Services, or who have not had their application acted on with reasonable promptness, may appeal to the North Dakota Department of Human Services.

Nondiscrimination Policy and Related Information

Client Rights and Appeals

Medium

To File an Appeal:

  1. An appeal can be filed verbally over the phone, or in written format by email, fax or mail.
  2. A request to appeal must be filed no later than 30 days from the date the notice of action is mailed.
  3. You can use  SFN 162: Request for Hearing to file the appeal but it is not required.
  4. You are not required to sign SFN 162: Request for Hearing to submit the appeal request.
  5. If you do not use SFN 162: Request for Hearing, please provide your name, contact information, and program decision or error that you are appealing.
Medium

Translations

Language Assistance and Auxiliary Aids and Services are available at no cost.

Medium

Medicaid Appeals Contacts

Appeals Supervisor, Legal Advisory Unit
N.D. Department of Human Services
600 E Boulevard Avenue, Dept. 325
Bismarck, ND 58505-0250

Phone: (701) 328-2311
Toll-Free: (800) 472-2622
FAX: (701) 328-2173
Email: dhslau@nd.gov

ND Relay TTY: 711