Office of Health Care Ombudsman and Bill of Rights

Office of Health Care Ombudsman and Bill of Rights
 

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Grievances/Appeals

What are Grievances/Appeals (Health Benefits Plan Members' Bill of Rights)?

The Health Benefits Plan Members' Bill of Rights is a District of Columbia law that gives any Member of a Health Maintenance Organization (HMO) or other Health Insurance Plans the right to appeal if they are denied coverage. This applies to any health insurance plan’s decision that results in denial, reduction, limitation, termination or delay in covered health care services by the HMO or health plan insurer.

Grievances/Appeals (Health Benefits Plan Members' Bill of Rights) Fact Sheet/Forms