GRIEVANCE AND APPEALS. CONTRACTOR shall follow all federal regulations for processing grievances and appeals. Clarification and guidance can be located in Information Notice 18-010E on the DHCS website at: xxxxx://xxx.xxxx.xx.xxx/formsandpubs/Pages/2018_BH_Information_Notices.aspx
GRIEVANCE AND APPEALS. 17.1. CONTRACTOR shall follow all federal regulations for processing grievances and appeals. Clarification and guidance can be located in Information Notice 18-010E on the DHCS website at: xxxxx://xxx.xxxx.xx.xxx/formsandpubs/Pages/2018_BH_Information_Notices.aspx
17.2. The CONTRACTOR shall provide information to all beneficiaries, prospective beneficiaries, and members of the public on how to file a Discrimination Grievance with:
17.2.1. The COUNTY and the Department if there is a concern of discrimination based on sex, race, color, religion, ancestry, national origin, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status, gender, gender identity, or sexual orientation. (Welf. & Inst. Code § 14727(a)(4))
17.2.2. The United States Department of Health and Human Services Office for Civil Rights if there is a concern of discrimination based on race, color, national origin, sex, age, or disability. (Welf. & Inst. Code § 14727(a)(5))
GRIEVANCE AND APPEALS. System means the overall system that includes Grievances and Appeals handled at the MCO and access to the State Fair Hearing (also called state appeal) process.
GRIEVANCE AND APPEALS. This section outlines the procedures for and the time periods applicable to grievances and appeals. The Insured, the Insured’s authorized representative, or Physician or health care provider has the right to file a Grievance, file an appeal, and have an External review. It is the policy of this Company to provide Insureds with a full and fair review of grievance and appeal decisions.
GRIEVANCE AND APPEALS. 12.4.1. Contractor shall follow all federal regulations for processing grievances and appeals. Clarification and guidance can be located in Information Notice 18-010E on the DHCS website at: xxxxx://xxx.xxxx.xx.xxx/formsandpubs/Pages/2018_BH_Information_Notices.aspx
GRIEVANCE AND APPEALS a. Disciplinary actions are grievable through the negotiated grievance procedure article.
b. Adverse actions may be grieved or appealed to the Merit Systems Protection Board (MSPB), but not both.
GRIEVANCE AND APPEALS. Dentist shall cooperate in a timely manner with grievance and appeal procedures established from time to time by MA Plan. Such cooperation shall include, but is not limited to, gathering and forwarding requested information to MA Plan within the timeframes reasonably established by MA Plan. Dentist shall comply with final determinations of MA Plan or its designee with respect to Dentist and MA Member grievances and appeals. The parties acknowledge that Dentist’s right to appeal an administrative denial is in addition to any MA Member appeal rights established by applicable law or regulation.
GRIEVANCE AND APPEALS. Data is amended by DELETING the first paragraph in its entirety and REPLACING with the following, “The Contractor agrees to submit reports in the appropriate format and timetables identified by EOHHS within this contract and as specified in Reporting Calendar. The Contractor agrees to submit quarterly reporting for Complaints, Grievance and Appeals submitted to the Plan. Reports will be inclusive of all Lines of Business identified in this contract.” Section is further amended by REPLACING the first sentence of paragraph two as follows, “In accordance with 42 C.F.R. §438.416, the Contractor will provide the following with each record of a grievance or appeal:”.
GRIEVANCE AND APPEALS. The CONTRACTOR shall have a grievance system in place for Members that includes a grievance process related to dissatisfaction, and an appeals process related to a CONTRACTOR action, including the opportunity to request an HSD Fair Hearing. For purposes of this Article, the following definitions apply:
GRIEVANCE AND APPEALS. If the disputes cannot be resolved through the LRE Provider Grievance and Appeal Policy process, either Party may seek any available legal and/or exhaustion of remedies.
