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Indiana Administrative Code (Last Updated: December 20, 2016) |
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Title 405. OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES |
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Article 405IAC5. MEDICAID SERVICES |
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Rule 405IAC5-21.7. Child Mental Health Wraparound Services |
Section 405IAC5-21.7-21. Complaints and grievances
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(a) An applicant, a member, and the family of an applicant or a member shall have the right to file a complaint or grievance in writing with the state regarding CMHW service providers or CMHW services. All complaints and grievances are accepted by the following means:
(1) Delivery to the family-consumer section on the DMHA website.
(2) Delivery in-person to a DMHA staff member.
(3) Delivery via written complaint or e-mail that is submitted to the DMHA.
(b) The receipt of a complaint or grievance shall be recorded in the office's data system with a copy attached to the provider's file. An investigation shall begin within seventy-two (72) hours of receipt of the complaint or grievance.
(c) When an investigation is complete, the following shall occur:
(1) The individual filing the complaint or grievance shall be informed of the office's investigative findings through a letter from an office staff member.
(2) The individual who filed a grievance or complaint must be informed that filing a grievance or complaint is neither a prerequisite nor a substitute for a fair hearing.
(d) If indicated by the results of an investigation, a letter of findings shall be sent to the CMHW service provider who is the subject of the complaint or grievance. The CMHW service provider shall correct any identified deficiency within the timeline established by the office.
(e) If the CMHW service provider fails to correct the deficiency within the established timeline, the office may pursue sanctions up to, and including, revoking authorization for the provider to deliver CMHW services. (Office of the Secretary of Family and Social Services; 405 IAC 5-21.7-21; filed Dec 18, 2013, 11:13 a.m.: 20140115-IR-405130211FRA; filed Aug 1, 2016, 3:44 p.m.: 20160831-IR-405150418FRA)