§432E-5 Complaints and appeals procedure for enrollees. (a) A managed care plan with enrollees in this State shall establish and maintain a procedure to provide for the resolution of an enrollee's complaints and appeals.

(b) The managed care plan at all times shall make available its complaints and appeals procedures. The complaints and appeals procedures shall be reasonably understandable to the average layperson and shall be provided in languages other than English upon request.

(c) A managed care plan shall send notice of its final internal determination to the enrollee, the enrollee's appointed representative, if applicable, and the commissioner. The notice shall include information regarding the enrollee's rights and procedures under section 432E-6. [L 1998, c 178, pt of §2; am L 1999, c 137, §5]