L.V.
v.
SUNSHINE STATE HEALTH PLAN, INC.
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A fair hearing request filed more than 120 days after the Agency sends the required Notice of Plan Appeal Resolution is untimely and subject to dismissal.
[1] A fair hearing request under Florida Medicaid regulations must be received by the Agency for Health Care Administration within 120 days of the date the Notice of Plan App…
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Join FLexlaw to unlock all legal intelligenceL.V., as designated representative for Medicaid recipient A.V., requested a Medicaid fair hearing 183 days after Sunshine State Health Plan issued a N…
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Third District Court of Appeal State of Florida
Opinion filed April 30, 2025. Not final until disposition of timely filed motion for rehearing.
________________
No. 3D24-1389 Lower Tribunal No. 24-FH1970 ________________
L.V., Appellant,
vs.
Sunshine State Health Plan, Inc., Appellee.
An Administrative Appeal from the State of Florida, Agency for Health Care Administration, Office of Fair Hearings.
L.V., in proper person.
Hogan Lovells US LLP, and Craig H. Smith, for appellee.
Before SCALES, GORDO and BOKOR, JJ.
PER CURIAM.
2
L.V., as designated representative on the behalf of A.V., a Medicaid recipient under a plan administered by Sunshine State Health Plan, Inc. (“Sunshine Health”), appeals a final administrative order of the Agency for Health Care Administration (the “Agency”) dismissing L.V.’s request for a Medicaid Fair Hearing. Because the Agency received L.V.’s request 183 days after Sunshine Health denied L.V.’s appeal and issued a Notice of Plan Appeal Resolution (“NPAR”), along with information regarding L.V.’s right to request a fair hearing, and L.V.’s initial brief fails to identify any specific error below, we affirm the challenged order. See Fla. Admin. Code R. 59G- 1.100(8)(g) (“A fair hearing request by an enrollee must be received by the Agency within 120 days of the date the required NPAR is sent to the enrollee.”); Fla. Admin. Code R. 59G-1.100(9)(b)3. (“A Hearing Officer is authorized to deny or dismiss a request for a fair hearing for reasons consistent with this rule, including the following: . . . [a] fair hearing request is untimely[.]”); V.T. v. Liberty Dental Plan of Fla., Inc., 338 So. 3d 989, 989- 90 (Fla. 3d DCA 2022). Affirmed.