Tex.
Gov't Code Section 532.0053
Grievances
(a)
The commission shall:(1)
adopt a definition of “grievance” related to Medicaid and ensure the definition is consistent among divisions within the commission to ensure all grievances are managed consistently;(2)
standardize Medicaid grievance data reporting and tracking among divisions within the commission;(3)
implement a no-wrong-door system for Medicaid grievances reported to the commission; and(4)
verify grievance data a Medicaid managed care organization reports.(b)
The commission shall establish a procedure for expedited resolution of a grievance related to Medicaid that allows the commission to:(1)
identify a grievance related to a Medicaid access-to-care issue that is urgent and requires an expedited resolution; and(2)
resolve the grievance within a specified period.(c)
The commission shall:(1)
aggregate recipient and Medicaid provider grievance data to provide a comprehensive data set of grievances; and(2)
make the aggregated data available to the legislature and the public in a manner that does not allow for the identification of a particular recipient or provider.
Source:
Section 532.0053 — Grievances, https://statutes.capitol.texas.gov/Docs/GV/htm/GV.532.htm#532.0053 (accessed Jun. 5, 2024).
