The Centers for Medicare and Medicaid Services (CMS) recently issued a new version of the Medicare Advantage Provider Complaint Submission Form. The major change includes information pertaining to quality complaints. A new section on quality-related inquiries directs providers to submit quality-related complaints to a dedicated CMS Center for Clinical Standards and Quality (CCSQ) mailbox at BFCCQIOConcerns@cms.hhs.gov. Please note, you must be authorized to represent the patient and have a quality-related complaint before submission.
The new form also provides guidance on bundling complaints. Per the instructions, if you have multiple complainants/patients for the same Medicare Advantage Prescription Drug plan, you may bundle them in one email to MedicarePartCDQuestions@cms.hhs.gov; however, make sure to complete/submit one form per individual. The ability to bundle multiple complaints into a single email comes as a result of staffing reduction and high volumes. CMS maintains its commitment to looking at all complaints. Complaints will still be entered into the Complaints Tracking Module (CTM) for tracking and resolution.
KHA members can access the new form, along with other Medicare Advantage resources at the link below.
