New York State Medicaid Managed Care Grievances Timeframe Chart
- Chart is also available in Portable Document Format (PDF)
Revised: February 2, 2018
| MMC/FHP Contract Appendix F Complaints (excludes Referral & Benefit Determinations) |
MLTC Partial Cap. Contract Appendix K |
4/1/18 Appendix F, Appendix K, State Law and 42 CFR 438 |
|
|---|---|---|---|
| Filing | N/A | N/A | Any time |
| Acknowledgement | 15 business days | 15 business days | 15 business days |
| Resolution | |||
|
48 hours but not > 7 days | 48 hours but not > 7 days Up to 14 day extension | 48 hours after all info; not > 7 days |
|
45 but not > 60 days | 45 but not > 60 days Up to 14 day extension | 45 days after all info; not > than 60 days |
| Appeals | |||
| Filing | 60 business days | 60 business days | 60 business days |
| Acknowledgement | 15 business days | 15 business days | 15 business days |
| Resolution | |||
|
2 business days after all info | 2 business days after all info | 2 business days after all info |
|
30 business days after all info | 30 business days after all info | 30 business days after all info |
