South Carolina Code 38-33-110. Complaint procedures; reports; malpractice claims; applicability of Freedom of Information Act
(2) Each health maintenance organization, with the annual report required in § 38-33-90, shall submit to the department an annual report in a form the director prescribes which must include:
Terms Used In South Carolina Code 38-33-110
- Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
- Department: means the Department of Insurance of South Carolina. See South Carolina Code 38-1-20
- Director: means the person who is appointed by the Governor upon the advice and consent of the Senate and who is responsible for the operation and management of the Department of Insurance, including all of its divisions. See South Carolina Code 38-33-20
- Freedom of Information Act: A federal law that mandates that all the records created and kept by federal agencies in the executive branch of government must be open for public inspection and copying. The only exceptions are those records that fall into one of nine exempted categories listed in the statute. Source: OCC
- Health maintenance organization: means a person who undertakes to provide or arrange for basic health care services to enrollees for a fixed prepaid premium. See South Carolina Code 38-33-20
(a) a summary of written complaints handled through the health maintenance organization’s approved complaint system. The summary must include the total number of complaints organized by the nature of the complaint and the average time taken to resolve the complaint;
(b) the number, amount, and disposition of malpractice claims made by enrollees of the health maintenance organization that it settled during the year.
(B) The director or his designee at any time may examine the complaint system. Information concerning complaints and malpractice claims filed pursuant to this section must be held in confidence and are not subject to disclosure under the Freedom of Information Act.