Appeals Process

You have a right to appeal and to receive an administrative fair hearing if you disagree with any agency actions.

The Executive Office of Health and Human Services (EOHHS) Appeals Office conducts administrative appeals hearings in accordance with the requirements of State law. See the appeal instructions and forms below.

Also, you may file an appeal (or an expedited appeal) and request Aid Pending by logging into your Account at www.healthyrhode.ri.gov. If you need assistance filing an appeal, please call HealthSource RI at (855) 840-4774. You may also fax your request to (401) 223-6317.

Appeal Instructions and Forms

Appeals Form - OHHS-121 (English) PDF file, less than 1

Appeals Form - OHHS-121 (Spanish) PDF file, less than 1

Appeals Form - OHHS-121 (Portuguese) PDF file, less than 1

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Appeals Process

Appeal Instructions and Forms