Sec. 26. (a) The department shall maintain records concerning complaints filed against a limited service health maintenance organization that provides dental care services.
(b) The department shall classify complaints described in subsection (a) in categories according to the NAIC standardized complaint report procedures or standardized complaint report procedures established by the department in rules adopted under IC 4-22-2.
(c) The department shall classify the disposition of complaints in each category by:
(1) number of complaints for which corrective action is considered necessary by the department; and
(2) number of complaints classified by NAIC disposition codes or standardized disposition codes established by the department in rules adopted under IC 4-22-2.
(d) The department shall make information specified in this section available to the public in a form that does not identify any specific individual.
(e) A limited service health maintenance organization that provides dental care services may not take any retaliatory action, including cancellation or refusal to renew a participating provider contract, individual contract, or group contract, solely because a participating provider, enrollee, or individual or group contract holder files a complaint against the limited service health maintenance organization.
As added by P.L.91-2000, SEC.2. Amended by P.L.124-2018, SEC.97.
Structure Indiana Code
Article 13. Health Maintenance Organizations
Chapter 34. Limited Service Health Maintenance Organizations
27-13-34-0.1. Application of Certain Amendments to Chapter
27-13-34-1. "Enrollee" Defined
27-13-34-2. "Evidence of Coverage" Defined
27-13-34-3. "Limited Health Services" Defined
27-13-34-4. "Limited Service Health Maintenance Organization" Defined
27-13-34-5. "Provider" Defined
27-13-34-6. "Subscriber" Defined
27-13-34-7. Certificate of Authority Required; Foreign Entities
27-13-34-8. Application for Certificate of Authority; Requirements
27-13-34-9. Issuance of Certificate of Authority; Application Deficiencies; Denial of Application
27-13-34-10. Powers of Limited Service Health Maintenance Organization
27-13-34-11. Modification of Documents; Filing; Disapproval
27-13-34-12. Applicable Statutes
27-13-34-13. Evidence of Coverage; Required Information
27-13-34-14. Examinations by Commissioner
27-13-34-15. Required Contract Terms and Conditions; Exemptions
27-13-34-18. Fidelity Bonds; Deposit in Place of Bond
27-13-34-19. Annual Reports; Additional Reports
27-13-34-20. Suspension or Revocation of Certificate of Authority
27-13-34-21. Chapter Violations; Fines and Penalties
27-13-34-22. Supervision, Rehabilitation, or Liquidation; Remedies and Measures
27-13-34-24. Dental Care Services and Director; Review of Adverse Decisions; Complaints