Action:   The denial or limited authorization of a requested service, including the type or level of service:

• The reduction, suspension or termination of a previously authorized service;
• The denial, in whole or in part, of payment for a service;
• The failure to provide services in a timely manner;
• The failure to act within established timeframes for resolving an appeal or complaint and providing notice to affected parties; and
• The denial of the Title XIX/XXI eligible person’s request to obtain services outside the network.