Common use of Grievance System Clause in Contracts

Grievance System. The Contractor shall have in place a written grievance system process for subcontractors, enrollees and non- contracted providers, which define their rights regarding disputed matters with the Contractor. The Contractor’s grievance system for members includes a grievance process (the procedures for addressing member grievances), an appeals process and access to the State’s fair hearing process as outlined in Attachment F1, Enrollee Grievance System Standards. The Contractor’s dispute process for subcontractors and non-contracted providers includes a claim dispute process and access to the State’s fair hearing process as outlined in Attachment F2, Provider Claim Dispute Standards. The Contractor shall remain responsible for compliance with all requirements set forth in Attachments F1, Enrollee Grievance System Standards, F2, Provider Claim Dispute Standards, and 42 CFR Part 438 Subpart F.