L.A. Care will send you a Notice of Action (NOA) letter any time L.A. Care denies, delays, terminates or modifies a request for health care services.
If you disagree with L.A. Care’s decision, you can always file an appeal with L.A. Care. Go to the Appeals section above for important information on filing your appeal.
When L.A. Care sends you a NOA it will tell you all the rights you have if you disagree with a decision we made.
Contents in Notices
If L.A. Care bases denials, delays, terminations, or changes in whole or in part on medical necessity, your NOA must contain the following:
- A statement of the action L.A. Care intends to take.
- A clear and concise explanation of the reasons for L.A. Care’s decision.
- How L.A. Care decided, including the rules L.A. Care used
- The medical reasons for the decision. L.A. Care must clearly state how the member’s condition does not meet the rules or guidelines.
Translations
L.A. Care is required to fully translate and provide written member information in common preferred languages, including all grievance and appeals notices.
The fully translated notice must include the medical reason for L.A. Care’s decision to deny, delay, change, reduce, suspend, or stop a request for health care services.
If your preferred language is not available, the L.A. Care is required to offer verbal help in your preferred language so that you can understand the information you get.