Regulation .02-1 Member Complaints — Time Frames for MCOs to Respond to the Department.

Acknowledge an enrollee appeal or grievance reported to it by the Department’s complaint resolution unit within 1 business day;

Respond to the Department’s request for information regarding disputed nonemergency medical care actions within 3 business days;

Provide updates in a time frame specified by the Department;

Provide medical records within 5 days of the request; and

Provide a corrective action plan upon request and within the time frame specified, but not later than 10 days from the date of the request.