Sec. 10.09.57.12. Internal Grievance Procedure

A. The PCP shall have an internal grievance procedure which has been preapproved by the Department. The PCP shall provide a copy of its internal grievance procedures to all enrollees.

B. The internal grievance procedure may:

(1) Provide for the prompt resolution of any complaints of enrollees or their representatives;

(2) Assure the participation of individuals with the authority to require corrective action; and

(3) Require that a written record be made of all grievances and complaints by enrollees, and the responses taken by the PCP.

C. The PCP shall submit monthly reports to the Department that summarize any grievances and complaints, the actions taken by the PCP in response to the complaints and grievances, and the PCP's plans to address the problems raised in the complaints and grievances.