Sec. 1271.054.  INFORMATION ABOUT COMPLAINTS AND APPEALS.  (a)  An evidence of coverage must contain a clear and understandable description of the health maintenance organization's methods for resolving enrollee complaints, including:
(1)  the enrollee's right to appeal denial of an adverse determination to an independent review organization;  and
(2)  the procedures for appealing to an independent review organization.
(b)  A health maintenance organization may indicate a subsequent change to the methods for resolving enrollee complaints in a separate document issued to the enrollee.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.