Sec. 1355.2571. PARITY COMPLAINT PORTAL. (a) The commissioner shall develop and maintain a parity complaint portal that is an integrated system that allows for the enrollee of a health benefit plan to submit complaints of suspected violations of the provisions of this subchapter. The parity complaint portal must: (1) allow for an enrollee to submit a complaint through multiple ways; (2) provide updates on the status of an enrollee's complaint; (3) ensure timely, effective, and equitable resolution for submitted complaints; (4) include educational materials regarding: (A) benefits for mental health conditions and substance use disorders required under this subchapter; (B) an enrollee's rights and responsibilities under a health benefit plan concerning coverage under this subchapter; (C) circumstances under which a claim may be denied; and (D) the processes for reviewing a complaint submitted through the portal; (5) adhere to national best practices as determined by the commissioner; and (6) include the findings of the report required by Section 1355.2572 (b). (b) In developing the parity complaint portal under Subsection (a), the commissioner: (1) shall conduct an assessment of complaint portals and similar systems used by other relevant public or private entities; (2) shall develop best practice standards for complaint submissions and tracking consistent with the findings of the assessment conducted under Subdivision (1); and (3) may develop a new complaint portal or modify an existing complaint portal. (c) The Health and Human Services Commission shall appoint a liaison to the department to receive reports of concerns, complaints, and potential violations submitted through the parity complaint portal established under Subsection (a).
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