Texas § 532.0053 GRIEVANCES.

Texas Statutes

§ 532.0053 — GRIEVANCES.

Texas § 532.0053

Code GVGovernment Code

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Bluebook

Tex. Government Code Code Ann. § 532.0053 (2026).

Text

Sec. 532.0053. GRIEVANCES.

(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 with

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Sec. 532.0053. GRIEVANCES. (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.