Regulations of Connecticut State Agencies
(a) Grievance Process
The ASO shall have an organized grievance process under which a member may request review of an ASO decision. The process shall be described in the member handbook published by the ASO.
(b) Administrative Hearing
A member may request an administrative hearing from the department only after the ASO grievance procedure has been exhausted.
(c) Health Care Provider Appeal Process
(1) The ASO shall have an internal provider appeal process under which a health care provider may request review of a coverage or payment decision.
(2) The health care provider appeal process shall not include any appeal right to the department or any right to an administrative hearing.
(Adopted effective October 12, 2005)