Section 40Sec./Art. 40

Grounds for Grievances. - the following acts shall constitute valid grounds for grievance action:

a) any violation of the rights of patients;

b) a willfull neglect of duties of Program implementors that results in the loss or non-enjoyment of benefits by members or their dependents;

c) unjustifiable delay in actions on claims;

d) delay in the processing of claims that extends beyond the period agreed upon; and

e) any other act or neglect that tends to undermine or defeat the purposes of this Act.