Indiana Administrative Code
Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES
Article 10 - HEALTHY INDIANA PLAN
Rule 5 - Member Appeals
Section 5-2 - Member appeals; managed care organizations
Current through September 18, 2024
Authority: IC 12-15-44.5-9
Affected: IC 12-15-44.5
Sec. 2.
(a) A pending applicant, conditionally eligible individual, or plan member dissatisfied with the action of a managed care organization must first exhaust the managed care organization's internal appeals procedure prior to requesting a hearing with the state.
(b) After exhausting the managed care organization's internal appeals procedures, a pending applicant, conditionally eligible individual, or member may request an administrative hearing with the state no later than thirty-three (33) days from the date of the managed care organization's resolution of appeal.
(c) The state's hearing process shall be governed by the procedures and time limits set forth in 405 IAC 1.1.