PM 20-24-03: Complaints about MCOs

WAG 20-24-03.

Each MCO must establish and maintain a procedure for reviewing complaints by its clients. The grievance process must include an informal system, available internally, to attempt to resolve all complaints, and a formally structured grievance committee available for clients whose complaints cannot be handled informally. Final decisions of the grievance committee may be appealed by the client. Clients may also call the Health Benefits and All Kids Hotline with MCO complaints.