(a) Effective July 1, 2003, every plan with an internet website shall provide an online form through its internet website that subscribers or enrollees can use to file with the plan a grievance, as described in Section 1368, online. (b) The internet website shall have an easily accessible online grievance submission procedure that shall be accessible through a hyperlink on the internet websiteâs home page or member services portal clearly identified as âGRIEVANCE FORM.â All information submitted through this process shall be processed through a secure server. (c) The online grievance submission process shall be approved by the Department of Managed Health Care and shall meet the following requirements: (1) It shall utilize an online grievance form in HTML format that allows the user to enter required information directly into the form. (2) It shall allow the subscriber or enrollee to preview the grievance that will be submitted, including the opportunity to edit the form prior to submittal. (3) It shall include a current hyperlink to the Department of Managed Health Care internet website, and shall include a statement in a legible font that is clearly distinguishable from other content on the page and is in a legible size and type, containing the following language: âThe California Department of Managed Health Care is responsible for regulating health care service plans. If you have a grievance against your health plan, you should first telephone your health plan at (insert health planâs telephone number) and use your health planâs grievance process before contacting the department. Utilizing this grievance procedure does not prohibit any potential legal rights or remedies that may be available to you. If you need help with a grievance involving an emergency, a grievance that has not been satisfactorily resolved by your health plan, or a grievance that has remained unresolved for more than 30 days, you may call the department for assistance. You may also be eligible for an Independent Medical Review (IMR). If you are eligible for IMR, the IMR process will provide an impartial review of medical decisions made by a health plan related to the medical necessity of a proposed service or treatment, coverage decisions for treatments that are experimental or investigational in nature and payment disputes for emergency or urgent medical services. The department also has a toll-free telephone number (1-888-466-2219) and a TDD line (1-877-688-9891) for the hearing and speech impaired. The departmentâs internet website www.dmhc.ca.gov has complaint forms, IMR application forms, and instructions online.â The plan shall update the URL, hyperlink, and telephone numbers in this statement as necessary. (d) A plan that utilizes a hardware system that does not have the minimum system requirements to support the software necessary to meet the requirements of this section is exempt from these requirements until January 1, 2006. (e) For purposes of this section, the following terms shall have the following meanings: (1) âHome pageâ means the first page or welcome page of an internet website that serves as a starting point for navigation of the internet website. (2) âHTMLâ means Hypertext Markup Language, the authoring language used to create documents on the world wide web, which defines the structure and layout of a web document. (3) âHyperlinkâ means a special HTML code that allows text or graphics to serve as a link that, when clicked on, takes a user to another place in the same document, to another document, or to another internet website or page. (4) âMember services portalâ means the first page or welcome page of an internet website that can be reached directly by the internet websiteâs home page and that serves as a starting point for a navigation of member services available on the internet website. (5) âSecure serverâ means an internet connection to an internet website that encrypts and decrypts trans
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