RD62 - State Corporation Commission on the Activities of the Office of the Managed Care Ombudsman


Executive Summary:
This annual report on the activities of the Office of the Managed Care Ombudsman ("Office") covers the period from November 1, 2002, through October 31, 2003. During this time, the Office assisted approximately 1,000 consumers whose health insurance is provided by a Managed Care Health Insurance Plan ("MCHIP"). The Office provided general information, responded to specific questions from consumers, and assisted individuals that wanted to appeal an adverse decision their MCHIP issued denying a service or a claim. The Office continued its outreach and educational efforts to help consumers understand the benefits available from their MCHIP and provided tools to assist consumers in resolving problems. When applicable, consumers were referred to other regulatory agencies for assistance. We conclude that the Office continues to provide a valuable resource for consumers whose health insurance is provided by a Managed Care Health Insurance Plan.