The Centers for Medicare and Medicaid Services says that it reviews more than 100,000 complaints and appeals every year. Beneficiaries of the programs file around 16,000 complaints relating to hospital care and discharge orders as well as 18,000 complaints against nursing homes, home health services, and hospice programs. Another 30,000 complaints and appeals are specifically geared towards the Medicare Advantage programs. How Medicare handles its complaint and appeals process is no trivial matter, and the program has recently revised its complaint process.
Updated Medicare Complaint Process
On August 1, Medicare made a change to its complaint filing system: it added new, toll-free numbers to call to lodge a complaint. The new phone numbers represent a larger change in the Medicare complaint system. Each state used to have a quality improvement organization, or Q.I.O. Up until August 1, these organizations worked with providers on issues like hospital readmissions or preventing infections, reviewed beneficiary complaints, and expedited appeals.