Sec. 843.282. SUBMITTING COMPLAINTS TO DEPARTMENT. (a) Any person, including a person who has attempted to resolve a complaint through a health maintenance organization's complaint system process and is dissatisfied with the resolution, may submit a complaint to the department alleging a violation of: (1) this chapter; (2) Section 1367.053 ; (3) Subchapter A , Chapter 1452 ; (4) Subchapter B , Chapter 1507 ; (5) Chapters 222 , 251 , and 258 , as applicable to a health maintenance organization; or (6) Chapter 1271 or 1272 . (b) The commissioner shall complete an investigation of a complaint against a health maintenance organization to determine whether a violation has occurred not later than the 60th day after the date the department receives the complaint and all information necessary for the commissioner to make a determination. (c) The commissioner may extend the time necessary to complete an investigation if: (1) additional information is needed; (2) an on-site review is necessary; (3) the health maintenance organization, the physician or provider, or the complainant does not provide all documentation necessary to complete the investigation; or (4) other circumstances beyond the control of the department occur.
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