(a) A health maintenance organization shall provide an appeals process for a complainant
who is not satisfied with the resolution of the complaint. The appeals process must include the right of the complainant to:
(1) appear in person before a complaint appeal panel at the site at which the enrollee
normally receives health care services or at another site agreed to by the complainant;
(2) address a written appeal to the complaint appeal panel.
(b) The health maintenance organization shall send an acknowledgment letter to the
complainant not later than the fifth business day after the date the written request
for appeal is received.
(c) The health maintenance organization shall complete the appeals process not later
than the 30th calendar day after the date the written request for appeal is received.
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature or via Westlaw before relying on it for your legal needs.
Was this helpful?
Welcome to FindLaw's Cases & Codes
A free source of state and federal court opinions, state laws, and the United States Code. For more information about the legal concepts addressed by these cases and statutes, visit FindLaw's Learn About the Law.