Current through Pa Acts 2024-53, 2024-56 through 2024-111
Section 991.2142 - Appeal of complaint(a) An enrollee shall have fifteen (15) days from receipt of the notice of the decision from the second level review committee to appeal the decision to the department or the Insurance Department, as appropriate.(b) All records from the initial review and second level review shall be transmitted to the appropriate department in the manner prescribed. The enrollee, the health care provider or the managed care plan may submit additional materials related to the complaint.(c) The enrollee may be represented by an attorney or other individual before the appropriate department.(d) The appropriate department shall determine whether a violation of this article has occurred and may impose any penalties authorized by this article.1921, May 17, P.L. 682, No. 284, § 2142, added 1998, June 17, P.L. 464, No. 68, § 1, effective 1/1/1999.