Sec. 4201.204. COMPLAINT SYSTEM. (a) A utilization review agent shall establish and maintain a complaint system that provides reasonable procedures for the resolution of oral or written complaints initiated by enrollees, patients, or health care providers concerning the utilization review.
(b) The complaint procedure must include a requirement that the utilization review agent provide a written response to the complainant within 30 days.
(c) Repealed by Acts 2015, 84th Leg., R.S., Ch. 42 , Sec. 3.01(7), eff. September 1, 2015.
(d) A utilization review agent shall maintain a record of each complaint until the third anniversary of the date the complainant filed the complaint.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 4, eff. April 1, 2007.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 42 (S.B. 784), Sec. 3.01(7), eff. September 1, 2015.
Section: Previous 4201.152 4201.153 4201.154 4201.155 4201.201 4201.202 4201.203 4201.204 4201.205 4201.206 4201.207 4201.251 4201.252 4201.253 4201.301 NextLast modified: September 28, 2016