The CE or DBM shall have written provider complaint policies and procedures for an Enrollee, or an Enrollee's authorized representative, to appeal a CE's or DBM's action and/or file a grievance. The policies must address contractual requirements, including performance standards, and federal funding requirements, including 42 C.F.R. Part 438 Subpart F and OAC 317:2-3-10.

1. (1) Timeframes, pursuant to OAC 317:2-3-2;
2. (2) Notices, pursuant to OAC 317:2-3-8; and
3. (3) Recordkeeping, pursuant to OAC 317:2-3-11.

Added at 39 Ok Reg 450, eff 12-21-21 (emergency)

Added at 39 Ok Reg 1628, eff 9-12-22

Amended at 41 Ok Reg, Number 23, effective 9-1-24