Contact your Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) for complaints about the quality of care you got from a Medicare provider.
Quality of care complaints could include complaints about:
- Drug errors
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Like being given the wrong drug or being given drugs that interact in a negative way.
- Unnecessary or inappropriate surgery
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Like being operated on for a condition that could’ve been effectively treated with drugs or physical therapy.
- Unnecessary or inappropriate treatment
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Like being given the wrong treatment or treatment you didn’t need.
- Not getting treatment after your condition changed
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Like not getting treatment after abnormal test results or when you developed a complication.
- Getting discharged from the hospital too soon
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Like being sent home when you’re still in severe pain.
- Incomplete discharge instructions and/or arrangements
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Like being sent home from the hospital without instructions for the changes that were made in your daily medicine.
- Your health or drug plan
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Use the Medicare Complaint Form or follow the instructions in your plan membership materials to submit a complaint about your Medicare health or prescription drug plan.
- Customer Service
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For example, you think the customer service hours for your plan should be different.
- Access to specialists
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For example, you don’t think there are enough specialists in the plan to meet your needs.
- Improper care or unsafe conditions
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You may have a complaint about improper care (like claims of abuse to a nursing home resident) or unsafe conditions (like water damage or fire safety concerns). To file a complaint about improper care or unsafe conditions in a hospital, home health agency, hospice, or nursing home, contact your State Survey Agency. The State Survey Agency is usually part of your State department of health services.
- Hospital Conditions
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To file a complaint about conditions at a hospital (like rooms being too hot or cold, cold food, or poor housekeeping) contact your State department of health services.
- Your doctor
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To file a complaint about your doctor (like unprofessional conduct, incompetent practice, or licensing questions), contact your State medical board.
- Home health agencies
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If you have a complaint about the quality of care you’re getting from a home health agency, call the home health agency and ask to speak to the administrator. If you don’t believe your complaint has been resolved, call your state home health hotline. Your home health agency should give you this number when you start getting home health services.
- Kidney care
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Find out how to file a complaint about your dialysis or kidney care.