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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 53 Pa.B. 3392 (June 24, 2023).

31 Pa. Code § 154.13. Managed care plan reporting of complaints and grievances.

§ 154.13. Managed care plan reporting of complaints and grievances.

 (a)  Section 2111(13) of the act (40 P. S. §  991.2111(13)) requires managed care plans to report specific information to the Department of Health and the Department with respect to the number, type and disposition of all complaints and grievances filed with the managed care plan.

 (b)  Managed care plans shall report the information in subsection (a) to the Departments based on the format as required by the Departments.

 (c)  Notice of changes or amendments to the format for reporting complaint and grievance information will be published by the Department in the Pennsylvania Bulletin. The notice will provide for a 30-day public comment period. Changes in format will become effective 30 days after publication of the revised format in a subsequent edition of the Pennsylvania Bulletin.

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