Sec. 531.02131. GRIEVANCES RELATED TO MEDICAID. (a) The commission shall adopt a definition of "grievance" related to Medicaid and ensure the definition is consistent among divisions within the commission to ensure all grievances are managed consistently.
(b) The commission shall standardize Medicaid grievance data reporting and tracking among divisions within the commission.
(c) The commission shall implement a no-wrong-door system for Medicaid grievances reported to the commission.
(d) The commission shall establish a procedure for expedited resolution of a grievance related to Medicaid that allows the commission to:
(1) identify a grievance related to a Medicaid access to care issue that is urgent and requires an expedited resolution; and
(2) resolve the grievance within a specified period.
(e) The commission shall verify grievance data reported by a Medicaid managed care organization.
(f) The commission shall:
(1) aggregate Medicaid recipient and provider grievance data to provide a comprehensive data set of grievances; and
(2) make the aggregated data available to the legislature and the public in a manner that does not allow for the identification of a particular recipient or provider.
Added by Acts 2019, 86th Leg., R.S., Ch. 1330 (H.B. 4533), Sec. 2, eff. September 1, 2019.
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