§ 26-34-112 — Complaint system

(a) Each health maintenance organization shall establish
and maintain a complaint system which has been approved by the
commissioner, after consultation with the administrator, to
provide reasonable procedures for the resolution of written
complaints initiated by enrollees.
(b) Each health maintenance organization shall submit to
the commissioner and the administrator, an annual report, in a
form the commissioner prescribes, after consultation with the
administrator, which shall include:
(i) A description of the procedures of the complaint
system;
(ii) The total number of complaints handled through
the complaint system and a compilation of causes underlying the
complaints filed; and
(iii) The number, amount and disposition of
malpractice claims made by an enrollee of the organization that
were settled during the year by the health maintenance
organization. All such information shall be held in confidence
by the commissioner.
(c) The commissioner or the administrator may examine the
complaint system at any time.