Section 514B.14. Complaint system.

  1.  A health maintenance organization shall establish and maintain a complaint system which has been approved by the commissioner and which shall provide for the resolution of written complaints initiated by enrollees concerning health care services. A health maintenance organization shall submit to the commissioner an annual report in a form prescribed by the commissioner which shall include:

  a.  A description of the procedures of the complaint system.

  b.  The total number of complaints handled through the complaint system and a compilation of causes underlying the complaints filed.

  c.  The number, amount and disposition of malpractice claims settled during the year by the health maintenance organization and any of its providers.

  2.  The health maintenance organization shall maintain statistical information of written complaints filed with it concerning benefits over which the health maintenance organization does not have control and shall submit to the commissioner a summary report at the time and in the format that the commissioner may require. Complaints involving other persons shall be referred to those persons and a copy of the complaint sent to the commissioner.

[C75, 77, 79, 81, §514B.14]

92 Acts, ch 1162, §26

; 2012 Acts, ch 1023, §157