Common use of Appeals and Grievances Clause in Contracts

Appeals and Grievances. The MCP shall have written policies and procedures for an appeal and grievance system for members in compliance with the requirements of OAC rule 5160-26-08.4 and 42 CFR 438 Subpart F and shall include the participation of individuals authorized by the MCP to require corrective action. The MCP is prohibited from delegating the appeal or grievance process to another entity unless approved by ODM. These policies and procedures shall include a process by which members may file grievances and appeals with the MCP, and a process by which members may access the state’s fair hearing system through the Ohio Department of Job and Family Services (ODJFS) Bureau of State Hearings (BSH).

Appears in 16 contracts

Samples: Provider Agreement, Provider Agreement, Provider Agreement

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Appeals and Grievances. The MCP MCOP shall have written policies and procedures for an appeal and grievance system for members members, in compliance with the requirements of OAC rule 5160-2658-08.4 08.4, 42 CFR 422.564, and 42 CFR C.F.R. 438 Subpart F F, and shall include the participation of individuals authorized by the MCP MCOP to require corrective action. The MCP MCOP is prohibited from delegating the appeal or grievance process to another entity unless approved by ODM. These policies and procedures shall include a process by which members may file grievances and appeals with the MCPMCOP, and a process by which members may access the state’s fair hearing system through the Ohio Department of Job and Family Services (ODJFS) Bureau of State Hearings (BSH).

Appears in 11 contracts

Samples: Provider Agreement, Provider Agreement, Provider Agreement

Appeals and Grievances. The MCP MCOP shall have written policies and procedures for an appeal and grievance system for members members, in compliance with the requirements of OAC rule 5160-2658-08.4 08.4, 42 CFR 422.564, and 42 CFR C.F.R. 438 Subpart F F, and shall include the participation of individuals authorized by the MCP MCOP to require corrective action. The MCP MCOP is prohibited from delegating the appeal or grievance process to another entity unless approved by ODM. These The policies and procedures shall include a process by which members may file grievances and appeals with the MCPMCOP, and a process by which members may access the state’s fair hearing system through the Ohio Department of Job and Family Services (ODJFS) Bureau of State Hearings (BSH).

Appears in 6 contracts

Samples: Provider Agreement, Provider Agreement, Provider Agreement

Appeals and Grievances. The MCP shall have written policies and procedures for an appeal and grievance system for members members, in compliance with the requirements of OAC rule 5160-26-08.4 and 42 CFR 438 Subpart F F, and shall include the participation of individuals authorized by the MCP to require corrective action. The MCP is prohibited from delegating the appeal or grievance process to another entity unless approved by ODM. These policies and procedures shall include a process by which members may file grievances and appeals with the MCP, and a process by which members may access the state’s fair hearing system through the Ohio Department of Job and Family Services (ODJFS) Bureau of State Hearings (BSH).

Appears in 3 contracts

Samples: Provider Agreement, Provider Agreement, Provider Agreement

Appeals and Grievances. The MCP shall have written policies and procedures for an appeal and grievance system for members members, in compliance with the requirements of OAC rule 5160-26-08.4 and 42 CFR C.F.R. 438 Subpart F F, and shall include the participation of individuals authorized by the MCP to require corrective action. The MCP is prohibited from delegating the appeal or grievance process to another entity unless approved by ODM. These policies and procedures shall include a process by which members may file grievances and appeals with the MCP, and a process by which members may access the state’s fair hearing system through the Ohio Department of Job and Family Services (ODJFS) Bureau of State Hearings (BSH).

Appears in 2 contracts

Samples: Provider Agreement, Provider Agreement

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Appeals and Grievances. The MCP MCOP shall have written policies and procedures for an appeal and grievance system for members members, in compliance with the requirements of OAC rule 5160-26-08.4 5160‐58‐08.4 and 42 CFR C.F.R. 438 Subpart F F, and shall include the participation of individuals authorized by the MCP MCOP to require corrective action. The MCP MCOP is prohibited from delegating the appeal or grievance process to another entity unless approved by ODM. These policies and procedures shall include a process by which members may file grievances and appeals with the MCPMCOP, and a process by which members may access the state’s fair hearing system through the Ohio Department of Job and Family Services (ODJFS) Bureau of State Hearings (BSH).

Appears in 1 contract

Samples: Provider Agreement

Appeals and Grievances. The MCP MCOP shall have written policies and procedures for an appeal and grievance system for members members, in compliance with the requirements of OAC rule 5160-2658-08.4 and 42 CFR C.F.R. 438 Subpart F F, and shall include the participation of individuals authorized by the MCP MCOP to require corrective action. The MCP MCOP is prohibited from delegating the appeal or grievance process to another entity unless approved by ODM. These policies and procedures shall include a process by which members may file grievances and appeals with the MCPMCOP, and a process by which members may access the state’s fair hearing system through the Ohio Department of Job and Family Services (ODJFS) Bureau of State Hearings (BSH).

Appears in 1 contract

Samples: Provider Agreement

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