Filing a complaint with the Attorney General's Health Care Section

The Attorney General's Health Care Section was created to address consumer problems and complaints involving health care providers and health insurance companies - intervening in situations where consumers are unfairly denied medical treatment. 

Over the past three years the Health Care Section has responded to more that 10,000 consumer complaints, resulting in millions of dollars in savings or refunds for consumers who were denied treatment or billed for medical services that should have been covered.

The First Step - Before Filing a Complaint

If you have a problem with your HMO or Point of Service plan, we urge you to take the following steps before contacting the Attorney General's Office.

• Call your managed care plan member services department:
  Always call your managed care plan member services department first in order to give them a chance to address the problem. Many issues are quickly solved at this level in an informal manner.
  
• File a formal complaint or grievance with your plan:
  If your initial call does not solve the problem, call again and inform them that you wish to file either a formal complaint or a formal grievance.

NOTE: If your health plan is a "managed care plan", you may have certain rights under Act 68.  

Filing a complaint with the Attorney General may not preserve your appeal rights, pursuant to ACT 68 or Medicare. To preserve your rights, you must file a complaint or grievance appeal directly with your health plan or in conformance with the terms of your coverage.

Contacting the Attorney General's Health Care Section

If calls or formal complaints to your health care plan or medical service provider do not resolve your problem, we urge you to contact the Attorney General's Office.

Our Health Care Section has a toll-free line, 1-877-888-4877, which operates within Pennsylvania on weekdays between the hours of 10:00 AM and 3:00 PM.

You can also call the Health Care Section at 1-717-705-6938, weekdays from 8:30 AM until 5:00 PM.

There are two options for submitting health care complaint forms - either an online electronic complaint form or a printable PDF form, which can be downloaded, completed and mailed to our office along with any attachments or supporting information.

All documents related to health care complaints should be sent to the following address:

Office of Attorney General
Health Care Section
14th Floor, Strawberry Square
Harrisburg, PA 17120