When you have a concern about the quality of the medical care you are receiving from a health care facility (e.g., hospital, nursing home, home health agency) or professional, you can file a formal Medicare complaint through your Beneficiary and Family Centered Care-Quality Improvement Organization (BFCC-QIO). Examples of quality of care concerns include but are not limited to:
- Receiving the wrong medication
- Receiving an overdose of medication
- Receiving unnecessary surgery
- Receiving unnecessary diagnostic testing
- Experiencing a change in condition that was not treated
- Receiving a misdiagnosis
- Receiving inadequate discharge instructions
You should contact your BFCC-QIO if you:
- Need to discuss the quality of care received
- Want to file a formal quality of care complaint
- Need help understanding your Medicare rights
You should call 1-800-MEDICARE if you:
- Have a general question about Medicare coverage
- Need clarification about how to enroll in Medicare
- Wish to discuss billing issues
Trained staff are available to answer your questions about complaints and the filing process, provide assistance completing the Quality of Care Compliant Form and provide translation services.
You or your representative may contact your BFCC-QIO to have a Medicare Quality of Care Complaint Form sent to you by mail. You also can access the complaint form online. You can submit your complaint by mail or fax (emailed forms cannot be accepted) to your BFCC-QIO. Click here to find the BFCC-QIO for your state.
BFCC-QIOs offer an online tool to check your case status and follow it through each stage of the process. To check your case status, click here to locate the BFCC-QIO for your state. Next, click the Case Lookup or Case Status Check button on your BFCC-QIO’s website. You will need the case ID number you received when you first filed your complaint. Depending on your BFCC-QIO, statuses may only be available for certain types of cases.
To learn more about filing a complaint, visit Medicare.gov.