(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.

Text of section effective on April 01, 2025