Tex.
Ins. Code Section 1355.2571
Parity Complaint Portal
(a)
The commissioner shall develop and maintain a parity complaint portal that is an integrated system that allows for the enrollee of a health benefit plan to submit complaints of suspected violations of the provisions of this subchapter. The parity complaint portal must:(1)
allow for an enrollee to submit a complaint through multiple ways;(2)
provide updates on the status of an enrollee’s complaint;(3)
ensure timely, effective, and equitable resolution for submitted complaints;(4)
include educational materials regarding:(A)
benefits for mental health conditions and substance use disorders required under this subchapter;(B)
an enrollee’s rights and responsibilities under a health benefit plan concerning coverage under this subchapter;(C)
circumstances under which a claim may be denied; and(D)
the processes for reviewing a complaint submitted through the portal;(5)
adhere to national best practices as determined by the commissioner; and(6)
include the findings of the report required by Section 1355.2572 (Educational Materials and Parity Law Training; Report)(b).(b)
In developing the parity complaint portal under Subsection (a), the commissioner:(1)
shall conduct an assessment of complaint portals and similar systems used by other relevant public or private entities;(2)
shall develop best practice standards for complaint submissions and tracking consistent with the findings of the assessment conducted under Subdivision (1); and(3)
may develop a new complaint portal or modify an existing complaint portal.(c)
The Health and Human Services Commission shall appoint a liaison to the department to receive reports of concerns, complaints, and potential violations submitted through the parity complaint portal established under Subsection (a).
Source:
Section 1355.2571 — Parity Complaint Portal, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1355.htm#1355.2571 (accessed May 18, 2024).
