Use this form to notify the MassHealth Office of the General Counsel that a decision from the Board of Hearings on your pending MassHealth eligibility appeal is due to issue to you within fourteen (14) days of the ninety (90) day deadline for decisions.
The Board of Hearings is required to issue a decision on your MassHealth appeal within 90 days of the date your hearing took place, unless the hearing officer sent you a notice specifying any extensions to that deadline.
In order to for you to file a valid complaint to enforce the 90 day deadline under this new procedure in court if you do not receive your eligibility decision within the required 90 days, you must first have submitted a written demand to the Office of the General Counsel on this form notifying MassHealth that your eligibility decision from the MassHealth Board of Hearings was due to issue to you within fourteen (14) days of its due date, that you have not yet received a decision and that you are requesting that an eligibility decision be issued to you within the 90-day deadline.1
To submit this notification and demand for a decision to issue, you must complete this form within 14 days of the 90-day deadline. Earlier requests will not be acted upon.