№ lp_1_2_16410
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This document provides guidelines for Managed Care Entities (MCEs) on reporting grievance and appeal information to the Oregon Health Authority (OHA) in accordance with federal and state requirements.
Year:
2021
Region / City:
Oregon
Topic:
Healthcare Policy, Grievance and Appeal Systems
Document Type:
Instructional Guide
Organ / Institution:
Oregon Health Authority (OHA)
Author:
Oregon Health Authority (OHA)
Target Audience:
Managed Care Entities (MCEs)
Period of Validity:
Ongoing
Approval Date:
Not specified
Modification Date:
Not specified
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Year:
2023
Region / City:
Oregon
Topic:
Health Care, Managed Care Entities, Grievance and Appeal System
Document Type:
Instruction Manual
Agency / Institution:
Oregon Health Authority (OHA)
Author:
Oregon Health Authority (OHA)
Target Audience:
Managed Care Entities, Coordinated Care Organizations, Health Care Administrators
Period of Action:
Quarterly
Approval Date:
N/A
Date of Changes:
N/A
Year:
2024
Region / City:
N/A
Theme:
Procurement Process, Grievance Redressal System, Call Center Services
Document Type:
Meeting Minutes
Organization / Institution:
HRU PIU-IFRAP
Author:
HRU PIU-IFRAP Team
Target Audience:
Bidders, Procurement Participants
Period of Validity:
N/A
Date of Approval:
2nd October 2024
Date of Changes:
N/A
Year:
2026
Region / City:
Not specified
Subject:
Labor relations, grievance procedure, National Agreement, Step 4 settlements
Document Type:
Grievance statement
Organization / Institution:
National Association of Letter Carriers (NALC)
Author:
Not specified
Target Audience:
Union representatives, postal workers, management officials
Period of validity:
Not specified
Approval Date:
Not specified
Date of Amendments:
Not specified
Year:
[Year]
Region / City:
[Station/Post Office]
Subject:
Grievance regarding violation of Article 8, Section 5 of the National Agreement
Document Type:
Grievance
Organization:
[Union Name]
Author:
[Union Representative Name]
Target Audience:
Union representatives, management officials, employees involved in the grievance
Period of Validity:
[Quarter] of [Year]
Approval Date:
[Date]
Modification Date:
[Date]
Year:
2023
Region / City:
The Gambia
Theme:
Digital Integration, Stakeholder Engagement
Document Type:
Final Report
Organ / Institution:
Government of The Gambia
Author:
Unknown
Target Audience:
Stakeholders, Government Agencies, Project Beneficiaries
Period of Validity:
2023
Approval Date:
August 2023
Date of Amendments:
None
Year:
2025
Region / City:
Oregon
Subject:
Medicaid Grievance and Appeal System
Document Type:
Attestation
Organization:
Oregon Health Authority (OHA)
Author:
Medicaid Division, CCO Operations Unit
Target Audience:
Coordinated Care Organizations (CCOs)
Period of Action:
Contract Year 2025
Approval Date:
January 1, 2025
Amendment Date:
N/A
Year:
2025
Region / City:
Oregon
Subject:
Medicaid, Grievance and Appeal Systems
Document Type:
Policy
Organ / Institution:
Oregon Health Authority (OHA)
Author:
Medicaid Division CCO Operations Unit
Target Audience:
Coordinated Care Organizations (CCOs)
Effective Period:
Contract Year 2025
Approval Date:
March 27, 2025
Date of Changes:
None
Year:
2025
Region / City:
Oregon
Topic:
Grievance and Appeal Reporting
Document Type:
Instructional Guidelines
Organization / Institution:
Oregon Health Authority (OHA)
Author:
Oregon Health Authority
Target Audience:
Coordinated Care Organizations (CCOs) and relevant healthcare administrators
Period of Validity:
2025
Approval Date:
Not specified
Date of Changes:
June 17, 2025
Year:
2025
Region / City:
Oregon
Topic:
Grievance and Appeal Management
Document Type:
Instruction Manual
Organization / Institution:
Oregon Health Authority (OHA)
Author:
Oregon Health Authority (OHA)
Target Audience:
Coordinated Care Organizations (CCOs), healthcare providers, and relevant stakeholders
Period of Application:
CY 2025
Approval Date:
N/A
Date of Changes:
N/A
Year:
Not specified
Region / City:
Delhi
Subject:
Grievance Redressal
Document Type:
Committee Procedure
Organization:
Faculty of Management Studies, University of Delhi
Author:
Not specified
Target Audience:
Students of Faculty of Management Studies
Effective Period:
Not specified
Approval Date:
Not specified
Date of Amendments:
Not specified
Year:
2019
Region / City:
Queensland, Australia
Subject:
Employee grievance procedure
Document Type:
Form
Organization / Institution:
Queensland Department of Education
Author:
Queensland Government
Target Audience:
Public service employees
Effective Period:
N/A
Approval Date:
N/A
Modification Date:
N/A
Year:
2022
Region / City:
[Station/Post Office]
Subject:
Work hour limits, overtime
Document Type:
Grievance form
Organization / Institution:
[NALC]
Author:
[Union Representative]
Target Audience:
Union representatives, management
Period of validity:
[Date] through [Date]
Approval Date:
[Date]
Date of Changes:
[Date]
Note:
Year
Year:
2026
Region / City:
Global
Topic:
Grievance management, worker rights, gender-based violence
Document Type:
Template
Organization:
International Finance Corporation (IFC)
Author:
IFC
Target Audience:
Organizations implementing grievance mechanisms
Effective Period:
Ongoing
Approval Date:
2026
Date of Amendments:
N/A
Note:
Year
Topic:
Grievance Procedures, Consumer Rights
Document Type:
Policy
Organization / Institution:
Affiliate Santé Group
Target Audience:
Consumers receiving services from the Affiliate Santé Group
Description:
A policy document outlining the grievance procedures for consumers receiving services from the Affiliate Santé Group, detailing the steps and contacts for filing complaints or grievances.
Year:
2021
Region / City:
European Union
Topic:
Cross-border marketing of EU AIFs
Document type:
Notification letter
Author:
European Commission
Target audience:
AIFMs, regulatory bodies, financial institutions
Period of validity:
Not specified
Approval date:
Not specified
Amendment date:
Not specified
Year:
2023
Region / City:
Oregon
Topic:
Health Care, Managed Care Entities, Grievance and Appeal System
Document Type:
Instruction Manual
Agency / Institution:
Oregon Health Authority (OHA)
Author:
Oregon Health Authority (OHA)
Target Audience:
Managed Care Entities, Coordinated Care Organizations, Health Care Administrators
Period of Action:
Quarterly
Approval Date:
N/A
Date of Changes:
N/A
Note:
Year
Topic:
School Admissions
Document Type:
Application Form
Organization:
West Sussex County Council
Target Audience:
Parents of children seeking school placements
Year:
2025
Jurisdiction:
Wisconsin
Country:
United States
Document type:
Audit reporting requirements and reporting form
Program:
Managed Long-Term Care
Administering authority:
Department of Health Services, Division of Medicaid Services
Form number:
F-02022
Date of issue:
11/2025
Applicable entities:
Managed Care Organizations (MCOs)
Audit performer:
Independent certified public accountant (CPA) firm
Audit scope:
Claims processing for long-term care, acute, and primary services
Minimum sample size:
70 LTC claims; 85 total claims for FCP and PACE programs
Effective policy reference:
Residential services encounter reporting effective 02/01/2021
Coverage systems referenced:
ForwardHealth, DHS data warehouse
Note:
Year
Subject:
Managed Care, Medicaid, Health Insurance
Document Type:
Manual
Organization:
Health Care Authority (HCA), Department of Social and Health Services (DSHS)
Target Audience:
Staff, Health Care Providers