Subchapter 3 - Member Grievances and Appeals, Provider Complaints, and State Fair Hearings in Soonerselect
- Section 317:2-3-1 - Definitions
- Section 317:2-3-1 - [Effective 9/14/2024] Definitions
- Section 317:2-3-2 - Timeframes
- Section 317:2-3-2 - [Effective 9/14/2024] Timeframes
- Section 317:2-3-3 - Grievance and appeals system
- Section 317:2-3-3 - [Effective 9/14/2024] Grievance and appeals system
- Section 317:2-3-4 - Member grievances
- Section 317:2-3-4 - [Effective 9/14/2024] Member grievances
- Section 317:2-3-5 - Member appeals
- Section 317:2-3-5 - [Effective 9/14/2024] Member appeals
- Section 317:2-3-5.1 - Continuation of benefits pending appeal and state fair hearing
- Section 317:2-3-6 - External medical review and clinical expertise
- Section 317:2-3-6 - [Effective 9/14/2024] External medical review and clinical expertise
- Section 317:2-3-7 - Obligation to pay costs of services
- Section 317:2-3-7 - [Effective 9/14/2024] Obligation to pay costs of services
- Section 317:2-3-8 - Grievances and appeals notice
- Section 317:2-3-8 - [Effective 9/14/2024] Grievances and appeals notice
- Section 317:2-3-9 - Exhaustion of managed care entity appeals
- Section 317:2-3-9 - [Effective 9/14/2024] Exhaustion of CE or DBM appeals
- Section 317:2-3-10 - Provider complaint system
- Section 317:2-3-10 - [Effective 9/14/2024] Provider complaint system and appeal requests
- Section 317:2-3-11 - Recordkeeping
- Section 317:2-3-11 - [Effective 9/14/2024] Recordkeeping
- Section 317:2-3-12 - State fair hearing for members
- Section 317:2-3-12 - [Effective 9/14/2024] State fair hearing for members
- Section 317:2-3-13 - State fair hearing for providers
- Section 317:2-3-13 - [Effective 9/14/2024] State fair hearing for providers
- Section 317:2-3-14 - Administrative Law Judge (ALJ) jurisdiction
- Section 317:2-3-14 - [Effective 9/14/2024] Administrative Law Judge (ALJ) jurisdiction