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HMO Complaints and Regulators


FILE AN HMO COMPLAINT

Oversight is growing in the HMO marketplace. Should you have a complaint about an HMO practice... report it. We have listed below agencies in each of the 50 states along with a nation HMO accreditation review board. In a growing number of states, HMO complaints are being tallied and are often made public. Employer groups closely evaluate these complaints when determining which HMO contracts to accept each year. You can impact which HMO's will continue practicing in your area. Empowered patients make their voices heard, if you have to resolve your issue are still unhappy with your HMO treatment... file a complaint:

The Joint Commission on Acceditation of Healthcare Organizations (JCAHO) wants to know about your complaint. Send the complaint by e-mail, Fax or mail and include the name, street address, city and state of the health care organization.

E-Mail: complaint@jcaho.org

Fax: Office of Quality Monitoring
(630) 792-5636

Mail: Office of Quality Monitoring
Joint Commission on Accreditation of Healthcare Organizations
One Renaissance Boulevard
Oakbrook Terrace, IL 60181
Phone: (800) 994-6610


STATE HMO REGULATORS

In most states, the Department of Insurance monitors the activities of HMO's and will gladly take your complaints. California and Texas have specifically designed Departments' of Managed Care for this immediate purpose. These agencies frequently publish their statistics as they relate to the HMO complaints they have received. Please take the time to file your complaint. It is our hope that those HMO plans that are the least willing to accommodate patient concerns, be identified accordingly. File now:

California Department of Managed Care: www.opa.ca.gov

Texas Department of Managed Care: www.ers.state.tx.us

All 50 States Department of Insurance: www.insure.com/links/doi.html




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