Resolution of Enrollee Issues. Medicaid enrollees may file a grievance regarding any aspect of service delivery provided or paid for by the MCO. The enrollee may file an appeal to seek a review of an adverse action taken by the MCO as defined in 42 CFR 438.400(b). The MCO must submit to the Department a quarterly report summarizing each grievance and appeal handled during the quarter and a quarterly report summarizing all grievances.
Appears in 3 contracts
Samples: Service Provider Agreement, Purchase of Service Provider Agreement, Purchase of Service Provider Agreement
Resolution of Enrollee Issues. Medicaid enrollees may file a grievance regarding any aspect of service delivery provided or paid for by the MCO. The enrollee may file an appeal to seek a review of an adverse action taken by the MCO as defined in 42 CFR 438.400(b). The MCO must shall submit to the Department a quarterly report summarizing each grievance and appeal handled during the quarter and a quarterly report summarizing all grievances.
Appears in 1 contract
Resolution of Enrollee Issues. Medicaid enrollees may file a grievance regarding any aspect of service delivery provided or paid for by the MCOMCO at any time. The enrollee may file an appeal to seek a review of an adverse action taken by the MCO as defined in 42 CFR 438.400(b). The MCO must submit to the Department a quarterly report summarizing each grievance and appeal handled during the quarter and a quarterly report summarizing all grievances.
Appears in 1 contract
Samples: Service Provider Agreement
