New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 308 - MANAGED CARE PROGRAM
Part 15 - GRIEVANCES AND APPEALS
Section 8.308.15.9 - MCO PROVIDER GRIEVANCE
Current through Register Vol. 35, No. 18, September 24, 2024
A. Upon a provider contracting with the MCO, the MCO shall provide at no cost a written description of its provider grievance policies and procedures to the provider. The MCO will notify each of its providers in writing of any changes to these policies and procedures. The description shall include:
B. A provider or its authorized representative shall have the right to file a grievance with its MCO to express dissatisfaction about any matter or aspect of the MCO's operation. The provider or representative may file the grievance either orally or in writing in accordance with its MCO's policies and procedures.
C. The MCO shall designate a specific employee as its provider grievance manager with the authority to: