2025.04.26 Complaints, PA Appeals and Fair Hearings Presentation

TAHP’s presentation explains how Medicaid managed care plans handle prior authorizations, complaints, appeals, and fair hearings in Texas. These processes are grounded in federal and state law—they are designed to protect members while supporting providers in delivering appropriate care. Health plans use these pathways to ensure timely decisions, clinical integrity, and clear communication throughout the review process. Click here to view TAHP’s full presentation.

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