Handling of Grievances and Appeals. The Contractor shall adhere to the following record keeping, monitoring, and review requirements:
Handling of Grievances and Appeals. The grievance and appeal procedures shall be governed by the following requirements:
Handling of Grievances and Appeals. 43 9.5.1 General Requirements 43 9.5.2 Special Requirements for Appeals 44 9.6 Notice of Action 45 9.6.1 Language and Format Requirements 45 9.6.2 Content of Notice 45 9.6.3 Timing of Notice 45 9.7 Resolution and Notification 46 9.7.1 Specific Timeframes 47 9.7.2 Extension of Timeframes 47 9.7.3 Format of Notice 47 9.7.4 Content of Notice of Appeal Resolution 48 9.7.5 Requirements for State Fair Hearings 48 9.8 Expedited Resolution of Appeals 48 9.8.1 Punitive Action 48 9.8.2 Action Following Denial of a Request for Expedited Resolution 49 9.8.3 Failure to Make a Timely Decision 49
Handling of Grievances and Appeals. The Health Plan’s policies and procedures for handling Grievances and Appeals shall include the following requirements:
Handling of Grievances and Appeals. (42 CFR §438.406).
