Medicaid Managed Care Complaints Overview
There may be times when a Medicaid Managed Care enrollee or a provider is not satisfied with the care or services that a Medicaid Managed Care plan is providing to the enrollee. In those situations, enrollees and providers may file a formal complaint with the plan, the State, or both.
- Filing a complaint with the Medicaid Managed Care plan. A provider, enrollee, or an enrollee’s authorized representative can file a complaint with the plan. The Medicaid Managed Care plan will review the complaint and notify the person who made the complaint about the decision that is made. If the person who made the complaint disagrees with the plan’s decision, that person can file a “complaint appeal” with the Medicaid Managed Care plan.
- Filing a Complaint with New York State. A provider, enrollee, or an enrollee’s authorized representative can file a complaint with the State at any time. A complaint does not have to be filed with the plan before it can be filed with the State. Depending on the type of Medicaid Managed Care plan and the kind of complaint, there are different agencies that can help. Please see chart below for further information.
| NYS Medicaid Managed Care Enrollee and Provider Contacts for Questions/Complaints | |
| Type of Question/ Complaint | How to file/ Get more information |
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NYS Department of Health Bureau of Consumer Services Complaint Unit One Commerce Plaza, Room 1609 Albany, NY 12210 Phone: 1-800-206-8125 Email: Managed Care Complaints Information About Complaints and Appeals |
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NYS Department of Financial Services One Commerce Plaza Albany, NY 12257 Department of Financial Services Website |
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NYS Office of the Attorney General - Health Care Bureau The Capitol Albany, NY 12224-0341 Phone: 1-800-428-9071 Attorney General's Office Health Care Bureau Website |
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New York Medicaid Choice Phone: 1-844-HARP-999 (1-844-427-7999) -or- Local Department of Social Service (Medicaid Office) List of Local Departments of Social Services (Medicaid Offices) |
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NYS Office of Mental Health Phone: 1-800-597-8481 E-mail: For questions or comments related to behavioral health managed care: OMH Managed Care NYS OMH Managed Care Website |
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NYS Office of Alcoholism and Substance Abuse Services Phone: 518-473-3460 E-mail: PICM NYS OASAS Managed Care Website |
Please contact OMH Managed Care with any questions, comments, or problems you may be experiencing with this site. If you would like to file a complaint about behavioral health managed care, please visit the Information on Filing a Complaint page. Providers, if you have any questions about the managed care implementation, please complete and send a question form.