Buffalo caregivers appeal Medicaid decisions through Erie County DSS and a state Fair Hearing, not through HRA. If Medicaid is denied, reduced, or discontinued, request the OTDA-run hearing within 60 days, as NY Health Access explains in its Fair Hearing guide.
HRA handles Medicaid only in New York City. The other 57 counties use the local DSS office, according to MedicaidOffice in its New York application guide. A Fair Hearing is a state review run by the Office of Temporary and Disability Assistance.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Official resources:
- Apply through Erie’s official page — Use this page to review requirements and apply directly.
- Read the official guidance from Medicaidoffice — Use this primary source to verify the official guidance.
Table of Contents
- Where does a Buffalo caregiver start?
- How do you request a Fair Hearing?
- How do you keep services in place during the appeal?
- What if a plan cut the service?
- What if the hearing does not restore coverage?
Where does a Buffalo caregiver start?
Erie County DSS handles Medicaid locally in Buffalo. Its Medicaid office is at the Erie County Work Center, 158 Pearl Street, Buffalo, NY 14202. The office directs applicants to mail applications to PO Box 120, Buffalo, NY 14201-9903, according to Erie County DSS.
Start with the decision notice. Circle the notice date and the effective date. Keep the envelope, a copy of everything sent, and notes on calls.
How do you request a Fair Hearing?
OTDA offers four routes, described in the OTDA filing rules in the OTDA filing instructions. Keep proof of when you filed.
Note the date, time, and confirmation number. Store it with the notice.
- online
- by phone at 1-800-342-3334
- by fax to 518-473-6735
- by mail to OTDA Office of Administrative Hearings, P.O. Box 1930, Albany, NY 12201-1930
How do you keep services in place during the appeal?
To keep benefits unchanged during the appeal, generally request the hearing before the notice's effective date. That window is usually within 10 days of the notice, according to the Empire Justice Center in its Fair Hearing general information. Aid continuing means the current amount continues while the case is pending.
For dementia care, a gap can mean missed supervision or personal care. Ask for aid continuing on the request when the cut has an effective date. If the deadline already passed, file immediately and ask what options remain.
What if a plan cut the service?
Cuts by a Medicaid managed-care or Managed Long Term Care plan follow a different order. NY Health Access appeals guidance says the enrollee must first file the plan's internal appeal. After its final adverse determination, the enrollee can seek a state Fair Hearing.
Free independent help with MLTC complaints and appeals is available from ICAN, the state ombudsman program. The NYS Department of Health lists ICAN at 1-844-614-8800 and icannys.org. Call early when hours drop, staff stops coming, or letters use plan-appeal language.
What if the hearing does not restore coverage?
A caregiver who loses the Fair Hearing can still seek court review. Empire Justice Center explains the route as an Article 78 proceeding in NY Supreme Court.
It must be filed within 4 months of the hearing decision. Mark that four-month date when the written decision arrives. Keep the hearing decision, notices, and filing receipts together for legal help.
