Section 532.0053 - [Effective 4/1/2025] 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. (Gov. Code, Sec. 531.02131.)Tex. Gov't. Code § 532.0053
Added by Acts 2023, Texas Acts of the 88th Leg.- Regular Session, ch. 769,Sec. 1.01, eff. 4/1/2025.