Health care provider complaint

MGL c. 152 §13(3), requires the Health Care Services Board to receive and investigate complaints from employees, employers, and insurers regarding health care providers who provide services for workers' compensation claims.

Executive Director Diane Neelon, RN, JD, Office of Health Policy

The Details of Health care provider complaint

What you need for Health care provider complaint

How to file Health care provider complaint

The form and the medical release on the back of the form must be signed.

Send the form, the release, and supporting documentation to:

Health Care Services Board
Lafayette City Center
2 Avenue de Lafayette
Boston, MA 02111-1750
 

Next steps for Health care provider complaint

Types of complaints and the investigation

  • Patterns of discrimination against workers' compensation claimants;
  • Overutilization of procedures;
  • Unnecessary surgery or other procedures; or.
  • Other inappropriate treatment of compensation recipients.

Where the Board finds a pattern of abuse, it refers its findings to the appropriate board of registration.

Complaints may be filed by:

  • Employees
  • Employers, or
  • Insurers

about any health care provider who provides services for work related injuries. Incomplete complaints will be returned to the sender, stating the reasons for the return and notifying the sender that the complaint may be re-filed.

The HCSB will provide a copy of the complaint to the provider. Their response will be considered part of the HCSB's review of the complaint. Following the review, the HCSB will let the parties know what action has been taken with respect to the complaint.

If the complaint appears to be about an impartial physician on the Department of Industrial Accidents' roster, a copy will be forwarded to the senior judge who is responsible for the impartial program. The act of forwarding a complaint or response is not a recommendation or an opinion to the appropriateness of the provider to serve as an impartial physician.

Two members of the Complaint Sub-committee of the Health Care Services Board will review the complaint and make their recommendation to the Board at a future meeting. Each party will be notified of, and invited to speak before, the HCSB meeting where action will be taken .

Contact for Health care provider complaint

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