You have 30 calendar days from the date on the decision letter to ask Alliant Health Solutions to reconsider, with supporting documentation from your child’s physician. If that does not resolve it, you have 30 calendar days from the final letter to request a fair hearing before an Administrative Law Judge. Keep your child’s renewals going the whole time.
A denial or a cut in hours can feel final. It is not. Georgia’s GAPP rules give families two chances to have a decision looked at again, and each has a deadline that runs from the date printed on the letter, not the day you open it.
First, read the letter
If requested hours are not approved, the parent or guardian receives a certified letter (GAPP manual §825.4). It goes to the address the state has on file, so keep your address current with DFCS (§703.3). Note the date on the letter and count 30 calendar days from it. That is your deadline.
Why hours get denied or cut
Knowing the reason tells you what to send. Ask your agency for the exact reason given and for a copy of what was submitted. Common reasons include:
- The documentation did not show the need. Hours are based on your child’s specific medical treatment needs, confirmed by their medical records, and on the caregiver’s training needs (§702.1.4). If the records do not describe the care in detail, the review cannot count it.
- The packet was incomplete. A request that is still incomplete after 30 days is denied (§703.2.5).
- Caregivers are now trained. One of GAPP’s goals is to teach parents and caregivers to care for the child safely without a nurse (§825.5), so hours can go down as the caregiver skills checklist improves. If there are tasks you still cannot safely do, that needs to be documented.
Step 1: ask for a reconsideration within 30 days
You can ask Alliant Health Solutions to reconsider a denial or a reduction of services within 30 calendar days of the date of the notification letter (§831). Send it to:
Alliant Health Solutions
PO Box 105406
Atlanta, GA 30348
Attention: GAPP Review Nurse
A parent or legal guardian can also request it online. Either way, the request must include all your reasons and all supporting documentation from your child’s physician. If no reconsideration is requested in time, the decision becomes final (§831).
What to include
- A copy of the decision letter.
- A letter from your child’s physician explaining why the care is medically necessary, tied to specific tasks and how often they happen.
- Recent nursing notes, seizure logs and hospital discharge summaries that show the care in practice.
- Anything that has changed since the last approval: new equipment, a hospital stay, a new diagnosis.
- If hours were cut because caregivers are trained, a clear account of what you still cannot safely do alone, and why.
Send it in a way you can prove, and keep copies of everything.
Step 2: ask for a fair hearing within 30 days of the final letter
If the reconsideration does not resolve it, you can request a fair hearing before an Administrative Law Judge within 30 calendar days of the date of the Final Adverse Action Determination Letter (§833). Send it to:
Georgia Department of Community Health
DCH Legal, Floor 18
2 Martin Luther King Jr. Dr.
Atlanta, GA 30334
Include a copy of the final letter and state your specific reasons. The manual says you may request continuation of services, if applicable, when you ask for the hearing, so ask for it and confirm with your agency what applies (§833). Your agency can add information at any time during the appeal, and the judge’s decision will explain any further appeal rights.
Keep renewals going
While an appeal is open, your agency must still submit renewal packets by their due dates, or at least every three months (§818.10). Otherwise your child could win the appeal and be left without a current approval.
Getting help
- Your agency should help assemble the documentation. It filed the original request and has the records.
- The Georgia Advocacy Office advises people with disabilities and their families on their rights.
- Parent to Parent of Georgia can connect you with parents who have been through an appeal.
Children under 21 on Medicaid are covered by a federal rule known as EPSDT, which requires states to cover care that is medically necessary. If you believe hours were reduced for a reason other than your child’s needs, it is worth getting advice.
In short
- 30 calendar days from the letter to ask Alliant to reconsider, with your physician’s documentation.
- Then 30 calendar days from the final letter to request a fair hearing.
- Ask about continuing services when you request the hearing.
- Keep renewals going until it is over.
If your child’s GAPP hours have been denied or cut and you want a second opinion on the paperwork, tell us about your child. The full program rules are in our GAPP guide.
Common questions
How long do I have to appeal a GAPP decision?
You have 30 calendar days from the date of the decision letter to ask Alliant Health Solutions for a reconsideration. If the reconsideration does not resolve it, you have 30 calendar days from the date of the final letter to request a fair hearing before an Administrative Law Judge.
Where do I send a GAPP reconsideration request?
To Alliant Health Solutions, PO Box 105406, Atlanta, GA 30348, Attention: GAPP Review Nurse. A parent or legal guardian can also request it online. Include all your reasons and the supporting documentation from your child's physician.
Can I appeal if my child's GAPP hours are reduced at renewal?
Yes. A reconsideration can be requested for a denial or a reduction of services, within 30 calendar days of the date of the letter.
Do GAPP services continue during an appeal?
When you request a fair hearing, the manual says you may request continuation of services if applicable. Ask for it in your hearing request and confirm with your agency what applies. Keep submitting renewals during the appeal.
Sources
- Georgia Department of Community Health, Part II Policies and Procedures for Georgia Pediatric Program (GAPP) In-Home Nursing, July 1, 2025 edition, published on GAMMIS under Provider Manuals.
- Georgia Department of Community Health, Georgia Pediatric Program (GAPP) provider presentation, June 2023, published on the Georgia Medicaid Management Information System portal.
- Georgia Medicaid, Waiver Programs.
- Georgia Department of Community Health, Community Based Services.
- Georgia Advocacy Office, thegao.org.
Please read. This article is general information about a public program, not medical, legal or financial advice, and it is not a decision about your child. Program rules change. Confirm anything that matters with the Georgia Department of Community Health or with a GAPP participating agency before you rely on it.