Title 33, Chapter 21, Section 9
( 33-21-9)
(a) Every health maintenance organization shall establish and
maintain a complaint system which has been approved by the
Commissioner of Insurance after consultation with the commissioner
of human resources to provide reasonable procedures for the
resolution of written complaints initiated by enrollees or providers
concerning health care services. (b) The health maintenance organization shall maintain records of
written complaints concerning health care services for five years
from the time the complaints are filed and shall submit to the
Commissioner of Insurance a summary report at such times and in such
format as the Commissioner of Insurance may require. (c) The Commissioner of Insurance or the commissioner of human
resources may examine the complaint system at any time. |