CONFLICT OF INTEREST

A conflict of interest may arise when a local government unit owns a health plan and also owns and operates an ECP. In these circumstances, if an enrollee files a complaint against the health plan or the ECP, the local government unit shall: A. fully disclose in writing to every complainant that the health plan and the ECP are both owned and operated by local government unit; B. clearly explain in writing to every complainant that there is the potential for a conflict of interest when local government unit is both the provider and the contractor of the health service; and C. offer every complainant the option of filing the complaint with the appropriate state agency rather than with the health plan.