The state’s initiative to transition the majority of Illinois Medicaid patients to managed care organizations (MCOs) caused significant confusion and unease among health care professionals and patients. As a result, ISMS conducted the
Medicaid Managed Care survey
, which brought to light the frustrations and hassles experienced by health care professionals due to the transition. Our survey findings have been shared with the state, MCOs, the media and other stakeholders to make the case for improving the system.
The Illinois Department of Healthcare and Family Services (HFS) has launched a secure electronic web-based tool – the complaint portal – to assist you in resolving issues with Illinois Medicaid Managed Care Organizations (MCOs).
However, please note
that HFS requires that you attempt to work out the issue with the MCO BEFORE
submitting a complaint via the new portal.
When you access the portal to fill out the complaint form, read the top of the web page first for important instructions. Also be sure to have the following information handy: a description of the issue, the name of your contact at the MCO, and the patient ID number.
complaint portal. Issues that impact immediate access to care will be expedited.
While this is a step in the right direction, keep in mind that the complaint portal may still not resolve all issues and concerns.
The ISMS Advocacy team is interested in hearing about any problems you experience with the MCO initiative. Please
email us with a brief description of your problem to help us track and monitor physician complaints.