§ 23-99-410 - Grievance procedures.
23-99-410. Grievance procedures.
(a) A health care insurer issuing or delivering a managed care plan shall establish for those managed care plans a grievance procedure which provides covered persons with a prompt and meaningful review on the issue of denial, in whole or in part, of a health care treatment or service.
(b) (1) The covered person shall be provided prompt notice in writing of the outcome of the grievance procedure.
(2) In the event the outcome is adverse to the covered person, the notice shall include specific findings related to the grievance.