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A. MMP members have multiple avenues for contesting decisions that affect their health coverage, including EOHHS and CMS administrative fair hearings. The process is as follows: 1. MMP Grievances – Grievances directed toward the MMP may be internal or external. a. Internal or plan level grievances. MMP members, or their authorized representatives, can file a grievance with the MCO or a participating provider at any time by calling or writing the MCO or the provider. The MCO must require providers to forward grievances to the MCO. If the MMP member is requesting remedial action related to a Medicare issue, the member must file the grievance with the MCO or the provider no later than sixty (60) days after the event or incident triggering the incident (see Part 10-05-2 of this Title). The MCO must respond, orally or in writing, to an internal grievance within thirty (30) days after the MCO receives the grievance. The MCO must respond, orally or in writing, within twenty-four (24) hours whenever the MCO extends the timeframe for a decision or refuses to grant a request for an expedited grievance. b. External. MMP members, or their authorized representatives, can file a grievance by contacting 1-800-MEDICARE or EOHHS. Any grievance filed with EOHHS will be reviewed by a joint EOHHS- CMS contract oversight team and be made available to the MCO. 2. MMP Appeals – The process for handling appeals varies depending on whether the beneficiary is disputing an action related to Medicaid or Medicare coverage. For services covered under Medicare Part D, MMP members must follow the appeals process established by CMS in Subparts M and U of 42 C.F.R. Part 423. For services covered by Medicare Part A, Medicare Part B, and/or Medicaid in-plan services, MMP members must complete one (1) level of internal appeal before requesting an external review. Regulations governing the appeals process for Medicaid out-of-plan services are found in Part 10-05-2 of this Title. The process for filing subsequent appeals after the first level internal appeal is as follows: a. Services covered by Medicare Part A and/or B. Subsequent appeals after the first (1st) level internal appeal for traditional Medicare A and B services that are not fully in favor of the enrollee will be automatically forwarded to the Medicare Independent Review Entity (IRE) by the MMP. b. Services covered by Medicaid only. Subsequent appeals for services covered by Medicaid only (including, but not limited to,