file medicaid complaint

False or fraudulent claims submitted to Medicare or Medicaid. Is my personal and complaint information kept confidential? For more information about Superior HealthPlan Medicare Advantage complaints and grievances, please click here. (AP Photo/Elise Amendola, file) ASSOCIATED PRESS By The Associated Press Published 10:53 AM PDT, June 21, 2023 (how to identify a Oregon.gov website) An OIG analyst will review your complaint for relevance and completeness. WebThe Colorado Attorney General wants to hear from you. 7500 Security Boulevard, Baltimore, MD 21244, Filing complaints about a doctor, hospital, or provider, Filing complaints about your health or drug plan, Filing a complaint about durable medical equipment (DME), Authorization to Disclose Personal Health Information (PDF), Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO), Find out how to file a complaint about your dialysis or kidney care, Find a Medicare Supplement Insurance (Medigap) policy. Las Vegas, NV Today, Attorney General Aaron D. Ford announced that Joy Behavioral Health, LLC (Joy) and its owner Edward Gamboa was sentenced in a Medicaid fraud case involving billing for services that were not provided to Medicaid recipients. Staff are available to assist you Monday through Friday, 8am PhRMA said in a federal court complaint filed Wednesday, June 21, 2023, that the act forces drugmakers to agree to a government-dictated price under the threat of a heavy tax. HHS-OIGs Hotline reviews and investigates thousands of complaints each year. They can help resolve Visit SMMCfor more information. If the issue involves a Medicaid Managed Care Plan, you should use the plans provider complaint process prior to submitting a complaint to the Agency. Report it to Social Security Administration OIG, SNAP/Food Stamp Fraud. You can also file an appeal by phone, fax, mail, email or in person. The name and contact information of any individual who can help corroborate the information you are reporting. If you suspect that there may have been illegal or unethical billing practices, including fraudulent billing, upcoding, and balance billing, then it is important to file an W196, Indianapolis, IN 46204, unless there has been an award. WebOffice of the Medicaid Inspector General: For suspected fraud, waste or abuse complaints/allegations, call 1-877-87FRAUD, (877) 873-7283, or visit Office of Medicaid Inspector General (OMIG) web site. Contact yourBeneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO)for complaints about the quality of care you got from a Medicare provider. Follow us on Twitter The complainant may provide a name, address and phone number to the Department. We will not be unfair to you because you complained. If you want your services to stay the same while you appeal, you must file your appeal no later than ten (10) calendar days from the date on the Departments letter informing you of its denial or action. ], 2023 Florida Agency for Health Care Administration, Florida Center for Health Information and Transparency, Florida Medicaid Providers How to File a Complaint, Florida Medicaid Recipients - How to File a Complaint, General Medicaid Issues How to File a Complaint, Medicare Dual Eligible Special Needs Plans (D-SNPs), To submit a complaint online you may use the. How do I know if my county office is currently a Universal Caseload (UCL) office? The more you tell us, the better chance we have of determining whether an investigation can be pursued. Department of Banking and Insurance. Information on the Food Assistance Program, eligibility requirements, and other food resources. Efforts by the Medicaid Fraud Control Unit (MFCU) of the Office of the Attorney General of Texas (OAG) have led to a home health company owner being sentenced to prison for 57 months. For reporting abuse, neglect, or exploitation of children, the elderly or people with disabilities, please visit the Texas Abuse Hotline or call 1-800-252-5400. To file a complaint about your doctor (like unprofessional conduct, incompetent practice, or licensing questions),contact your State medical board. Your complaint can be filed anonymously, however if you wish to know the results of your complaint, you should be prepared to give your name, address and telephone number. The MFCU receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $20,944,200 for fiscal year (FY) 2023. Attn: Complaints Department The Consumer Services Division of the Department of Insurance stands ready to assist you in resolving insurance problems with companies licensed in Indiana. The Departments Central Complaint Registry is limited to the mandates provided in the licensing acts, regulations, and federal Medicare Conditions of Participation or coverage for the programs the Department manages. OIG Hotline Operations is not a statutory entity, court, or other administrative body. Programs for healthy children & families, including immunization, lead poisoning prevention, prenatal smoking cessation, and many others. Learn about out-of-network payment disputes between providers and health plans and how to start the independent dispute resolution (IDR) process, apply to become a certified independent dispute resolution entity, or submit a petition on an applicant or to revoke certification of a current IDR entity. Provider Payments Information on the direct deposit of State of Michigan payments into a provider's bank account. Examples of LANSING Today, Willie Reed turned himself in and was arraigned on felony charges stemming from allegations that he and two others defrauded the 2022 gubernatorial campaigns of Perry Johnson, James Craig, Donna Brandenburg, Michael Request Network Participation, Non-Contracted Providers Only, Add a Provider to an Existing Group Contract, Add a Practice Location to an Existing Contract, Practice Improvement Resource Center (PIRC), Updating Provider Demographic Information, Effective 1/1: Electronic Prescribing of Controlled Substances Required, Effective September 1, 2021: Benefit Changes to Total Disc Arthroplasty for Medicaid and CHIP, Effective July 15, 2021 through December 31, 2021: Temporary Relaxation of Prior Authorization Requirements for DME, Orthotic, and Enteral/Parenteral Nutrition and Medical Supplies, Javelina legend and NFL hall of famer Darrell Green gives back to Kingsville, Superior HealthPlan, Pro Football Hall of Famer Darrell Green Help Make First Back-to-School Community Fair & Fest in Kingsville a Success, Provider Notice of Adverse Benefit Determinations, Superior to Override Timely Filing for Claims Impacted by Texas Medicaid Healthcare Partnerships (TMHP) Eligibility Verification Issues, https://www.tdi.texas.gov/consumer/get-help-with-an-insurance-complaint.html. You can appeal the action if you think Superior: You, a doctor or someone else acting on your behalf can appeal an action. If your complaint is regarding Medicaid eligibility or the application process, please contact the Department of Children and Families ACCESS Program. A .gov website belongs to an official government organization in the UnitedStates. Joy was sentenced for a gross misdemeanor offense of Intentional To ensure the safety of your protected health information (PHI), please send us a message through the Secure Member Portal or Provider Portal, or you can call us at the Member Services number on the back of your Superior ID card to speak directly to a customer service representative. WebThe Center for Medicaid and CHIP Services (CMCS) is committed to working in close partnership with states, as well as providers, families, and other stakeholders to support May 16, 2023 | Universal caseload, or task-based processing, is a different way of handling public assistance cases. Complaints may be filed by, but are not limited to, patients, patient family members, care givers, staff or advocacy groups. This process can be extended up to fourteen (14) days if you ask for an extension. Learn about out-of-network payment disputes between providers and health plans and how to start the independent TTY for the Hearing Impaired Only- 800-547-0466, Health Care Facilities Complaint Form File a Complaint Contact HFRD Complaint Intake Toll Free: (800) 878-6442 Fax: (404) 657-8935 Divisions & Offices The web Browser you are currently using is unsupported, and some features of this site may not work as intended. Box 12030 If you are covered by Medicare, you can file a complaint about your care with your State's Quality Improvement Organization (QIO) . Additionally, attachments that include enrollee information for multiple plans on the same document cannot be accepted. Insurers have 20 business days from receiving the complaint to respond. The defendants are charged with defrauding the Medicaid program through illicit practices committed through the Floss Family Dental Care clinic in Houston. Complaints can be filed by phone, mail, e-mail, or fax. If you think a person gave fraudulent information about his/her income, assets or living circumstances to qualify for Medicaid, please contact the Florida Department of Children and Families, Office of Public Benefits Integrity at Public Benefits Integrity | Florida DCF (myflfamilies.com). You can apply for Medicaid in one of the following ways: Find and check with your state's Medicaid agency to apply. . WebFile a complaint at Medicare.gov or call 1-800-MEDICARE Allegations by HHS employees of discrimination on the basis of race, gender, ethnicity, religion or sexual preference. Please note: The Indiana Department of Insurance has no jurisdiction over self-funded employer group health plans. Medicaid ID # (a letter and 6 #s on your card) Address and phone number. Or CHIP members can send a letter to: Texas Department of Insurance WebIf you need help submitting a complaint, you can call our Medicaid Helpline at 1-877-254-1055 (TDD 1-866-467-4970). Crime, gross misconduct, or conflicts of interest involving HHS employees, grantees or contractors, Fraud, waste, or abuse relating to HHS grants or contracts,. June 30, 2023. Information about the Michigan law that requires certain information be made available to a woman who is seeking an abortion at least 24 hours prior to the abortion procedure. Web800 NE Oregon Street, Suite 465 Portland, OR 97232 E-MAIL: mailbox.hclc@odhsoha.oregon.gov FAX:(971) 673-0556 If you have questions about the Health Care Facility/Agency Complaint Intake Form, please call (971) 673-0540. Resolving out-of-network payment disputes. BC/BS of IL - contact Illinois, BC/BS of KY contact Kentucky). Although additional information may be received during the course of a complaint, such items are part of the OIG Hotline file and its release is subject to OIG approval. WebTo file your complaint, call (888) 419-3456, or complete the Health Care Facility Complaint Form . TheState Survey Agency is usually part of yourState department of health services. This consent is not required. mail, e-mail orfax. Air quality across the state is being impacted by smoke from Canadian wildfires. 251.8 kB Central Complaint Registry Hotline - 800-252-4343 Or, a Superior Member Services Advocate can help you file an appeal. Fax: (609) 777-0508 or (609) 292-2431. It has known security flaws and may not display all features of this and other websites. (971) 673-0540. Information on adoption programs, adoption resources, locating birth parents and obtaining information from adoption records. June 30, 2023 LANSING Michigan Attorney General Dana Nessel issued the following statements in response to today's United States Supreme Court decisions: Biden v. Nebraska: Tens of millions of Americans have been saddled with significant student debt, limiting their opportunities. To report suspected abuse, neglect or exploitation of the elderly or a vulnerable adult, please contact the Florida Abuse Hotline at 1-800-96-ABUSE (1-800-962-2873). Mail to: IDOI Attn: Consumer Services Divsion 311 W. Washington Street, Suite 300 Indianapolis, IN 46204-2787. EMS and Trauma Systems Complaint Intake Form, Oregon Health Authority, EMS and Trauma SystemsProfessional Standards EnforcementPO Box 14450Portland, OR 97293, E-MAIL: Behavioral Risk Factor Surveillance System, Pregnancy Risk Assessment Monitoring System, Clinical Lab Improvement Amendments (CLIA), https://mc.insurance.illinois.gov/messagecenter.nsf, http://illinoisattorneygeneral.gov/consumers/hcform.pdf, https://www.idfpr.com/Admin/Complaints.asp, Long Term Care Incident and Communicable Disease Report, Serious Injury Incident Report Instructions, Grant Accountability and Transparency (GATA), Insurance billing issues should be referred to the Illinois Department of Insurance at, Possible health care fraud should be referred to the Attorney Generals Health Care Fraud Unit at, Licensed personnel issues should be addressed to the Illinois Department of Financial and Professional Regulation at, Mental health issues occurring and DHS-operated facilities can be referred to the Illinois Department of Human Services at, Medicare Billing Problems can be referred to a Medicare Customer Services Representative at. Superior will acknowledge your appeal within five (5) days of receipt, and complete the appeal within thirty (30) days. Trenton, NJ 08625-0475. In less than three months, the federal government is set to announce the initial 10 drugs subject to first-ever price negotiations in Medicare. Please note: if the claim involves Workers Compensation, direct your complaint to the Workers Compensation Board, 402 W. Washington St. Rm. To check the status of a long-term care complaint, contact the Departments Bureau of Long-Term Care at 800-252-4343. If you do not want to receive email responses, please let us know. This will reduce the data entry required for any future complaint submissions made from the same device and browser. The letter will inform you what action this office has authority to take, which may include an unannounced, onsite investigation. The investigation was conducted by Sergeant Alfred Paige, Investigative Auditor Daryl Middleton, and Captain Alexander Chancia of the Texas Attorney Generals Medicaid Fraud Control Unit (MFCU), in cooperation with the FBI and the Department of Health and Human Services - Office of Inspector General. Contact your agency's Equal Employment Opportunity officer, Allegations by employees or applicants concerning prohibited personnel practices; or Hatch Act violations. Attn: Consumer Services Divsion. Secure .gov websites use HTTPS Information on the grant awarded for the State Innovation Model Proposal, Offers resources for agencies who operate the Weatherization Assistance Program in the state of Michigan. This can include billing for services not rendered, billing for unnecessary services, and exaggerating (upcoding) the services or products provided. Has not paid for some or all of a service or a hospital bill. The email is not encrypted and is not transmitted in a secured format. Official websites use .gov 525 W. Jefferson St., Ground Floor WebYou must file a Notice of Appeal within 60 days of the date of the denial notice. You can appeal any decision, action, or inaction that you do not agree with that has been made by the Department of Human Services (DHS) or the Department of Healthcare and Family Services (HFS). What Next When your complaint is received at the Department it will be assigned a case number and you will receive an acknowledgement letter.

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