Section 550.1925 - Description of internal grievance and external review procedures; inclusion with materials provided to covered persons.
PATIENT'S RIGHT TO INDEPENDENT REVIEW ACT (EXCERPT)
Act 251 of 2000
550.1925 Description of internal grievance and external review procedures; inclusion with materials provided to covered persons.
Sec. 25.
(1) Each health carrier shall include a description of the internal grievance and external review procedures in or attached to the policy, certificate, membership booklet, outline of coverage, or other evidence of coverage it provides to covered persons.
(2) The description under subsection (1) shall be in plain English and shall include all of the following:
(a) A statement informing the covered person of his or her right to file a request for an internal grievance and external review of an adverse determination.
(b) The commissioner's toll-free telephone number and address.
(c) A statement informing the covered person that, when filing a request for an external review, the covered person will be required to authorize the release of any medical records that may be required to be reviewed for the purpose of reaching a decision on the external review.
History: 2000, Act 251, Eff. Oct. 1, 2000