Pennsylvania Code
Title 31 - INSURANCE
Part VIII - Miscellaneous Provisions
Chapter 154 - QUALITY HEALTH CARE ACCOUNTABILITY AND PROTECTION
REQUIRED PROVISIONS AND ENROLLEE DISCLOSURES
Section 154.13 - Managed care plan reporting of complaints and grievances

Universal Citation: 31 PA Code ยง 154.13

Current through Register Vol. 54, No. 44, November 2, 2024

(a) Section 2111(13) of the act (40 P. S. § 991.2111(13)) requires managed care plans to report specific information to the Department of Health and the Department with respect to the number, type and disposition of all complaints and grievances filed with the managed care plan.

(b) Managed care plans shall report the information in subsection (a) to the Departments based on the format as required by the Departments.

(c) Notice of changes or amendments to the format for reporting complaint and grievance information will be published by the Department in the Pennsylvania Bulletin. The notice will provide for a 30-day public comment period. Changes in format will become effective 30 days after publication of the revised format in a subsequent edition of the Pennsylvania Bulletin.

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