受益人問題解決流程
In accordance with Title 9, California Code of Regulations, Chapter 11, Subchapter 5, and the Mental Health Plan Contract, Mental Health Plans (MHP) must have problem resolution processes that enable a beneficiary to resolve a problem or concern about any issue related to the MHP’s performance, including the delivery of specialty mental health services.
Each MHPs beneficiary problem resolution process must include a system to receive and resolve beneficiary grievances, appeals, expedited appeals, and State Fair Hearings. The MHPs process must meet State and Federal requirements outlined in MHSUDS Information Notice 18-010E.
If a beneficiary disagrees with the MHP’s appeal or expedited appeal decision, the beneficiary may request a State Fair Hearing, or an Expedited State Fair Hearing.
年度受益人申訴及上訴報告（ABGAR）
衞生署須於 10 月 1 日每年向衞生護理署報告上一個財政年度內提出的投訴、上訴和加急上訴的總數，按類別和處置分類。
特殊條款和條件 #5 要求州必須在每年 11 月 1 日前向聯邦醫療保險和醫療補助服務中心提供年度的申訴和上訴報告。
The ABGAR statewide summary data is now housed on the California Health and Human Services Open Data Portal.