If you Have a Complaint about MLTC

You Can Contact Your Plan

Your managed long-term care (MLTC) plan will try its best to deal with your concerns or issues as quickly as possible and to your satisfaction. You may use either the plan's grievance process or its appeal process, depending on what kind of problem you have. You may file a grievance or appeal orally or in writing.

There will be no change in your services or the way you are treated by plan or health care provider staff because you file a grievance or an appeal. Your privacy will be maintained. You will get any help you may need to file a grievance or appeal from your MLTC plan. This includes providing you with interpreter services or help if you have vision and/or hearing problems. You may choose someone (like a relative or friend or a provider) to act for you.

Refer to your member handbook to learn how to use the plan’s grievance or appeal process or call the plan’s member services telephone number(s) listed in your member handbook. Your issue or problem may be able to be taken care of by talking to the plan staff.

You Can Contact Government Agencies

Managed long-term care enrollees can also ask certain government offices to investigate complaints. Depending on the type of health care plan involved and the kind of complaint, there are different agencies that can help. You do not have to file a complaint with your plan before you speak with or write to a government agent.

If you make a verbal complaint, you may be asked to send written information or documents to support your complaint. If you designate someone to make the complaint for you, you may be asked to sign a written authorization form to allow the government to share your personal health care information with your designee.

To file a complaint, find your issue on the chart below and contact the government agency listed through the phone number, website, or mailing address provided.

List of government agency complaint contacts

Who Issue Call Write
Anyone enrolled in a New York State Managed Long-Term Care Plan
  • dissatisfaction with quality of health care received
  • difficulty getting health care needed
  • Enrollment issues
  • Concerns about plan marketing
1-866-712-7197
NYS Department of Health
Bureau of Managed Long Term Care
Room 1911 Corning Tower
Empire State Plaza
Albany, NY 12237
Any Medicaid recipient enrolled in a New York State Managed Long-Term Care Plan
  • Medicaid eligibility
Local Department of Social Services Local Department of Social Services
Any Medicaid recipient enrolled in a New York State Managed Long-Term Care Plan
  • Fair Hearing request
Office of Temporary and Disability Assistance
1-800-342-3334
Fair Hearing Section
NYS Office of Temporary
and Disability Assistance
PO Box 22023
Albany, NY
12201-2023
FAX: (518) 473-6735