Section 405 IAC 10-5-2 - Member appeals; managed care organizationsAuthority: IC 12-15-44.5-9
Affected: IC 12-15-44.5
Sec. 2.
(a) A pending applicant, conditionally eligible individual, or plan member dissatisfied with the action of a managed care organization must first exhaust the managed care organization's internal appeals procedure prior to requesting a hearing with the state.(b) After exhausting the managed care organization's internal appeals procedures, a pending applicant, conditionally eligible individual, or member may request an administrative hearing with the state no later than thirty-three (33) days from the date of the managed care organization's resolution of appeal.(c) The state's hearing process shall be governed by the procedures and time limits set forth in 405 IAC 1.1. Filed 5/18/2015, 12:34 p.m.: 20150617-IR-405140339FRAFiled 1/19/2018, 8:42 a.m.: 20180214-IR-405170484FRA