Nebraska Statutes 44-32,136. Grievance procedure
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Each health maintenance organization shall establish and maintain a grievance procedure to provide for the resolution of grievances initiated by enrollees. The procedure shall be approved by the Director of Insurance after consultation with the Department of Health and Human Services. The Director of Insurance or the department may examine the grievance procedure. The health maintenance organization shall maintain records regarding grievances received since the date of the last examination.
Terms Used In Nebraska Statutes 44-32,136
- Department: shall mean the Department of Insurance. See Nebraska Statutes 44-103
- Director: shall mean the Director of Insurance. See Nebraska Statutes 44-3298
- Grievance: shall mean a written complaint submitted in accordance with the health maintenance organization's formal grievance procedure by or on behalf of the enrollee regarding any aspect of the health maintenance organization relative to the enrollee. See Nebraska Statutes 44-32,102
- Health maintenance organization: shall mean any person who undertakes to provide or arrange for the delivery of basic health care services to enrollees on a prepaid basis except for enrollee responsibility for copayments or deductibles. See Nebraska Statutes 44-32,105