The internal Managed Care Entity (MCE) appeal is less formal than a Human Services Board Fair Hearing appeal. In an MCE appeal, the decision about your services will be reviewed by a person in the Department of Disabilities, Aging and Independent Living (DAIL) who was not involved in the decision to deny services.
You must file a request for an internal MCE appeal within 90 days from when the decision was mailed to you.
After you file an internal MCE appeal, DAIL will schedule a meeting to review the appeal. They will send you a notice of the meeting time and place. You have the right to participate in the meeting about your appeal in person, by telephone or by writing.
You may give information that you think is important to your appeal. You can ask that the agency that made the decision you are appealing to provide you with all the information that was used to make the decision. The agency cannot make you pay for copies of the documents.
DAIL must have the meeting and send you a written notice of its decision within 45 days of your request for an internal MCE review.
The rules covering internal MCE appeals are found in Section 8.4 of the Vermont Developmental Disabilities Act Regulations.
Vermont Legal Aid may be able to assist you in your appeal. Contact us at 1-800-889-2047.