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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

The HCSB investigates complaint file by employees, employers, and insurers regarding health care providers who provide services to injured workers who are alleged to have engaged in patterns of:

  • discrimination against workers' compensation claimants;
  • overutilization of procedures;
  • unnecessary surgery or other procedures; or
  • other inappropriate treatment of compensation recipients

The HCSB will provide a copy of the complaint to the provider and any response will be considered part of the HCSB's review of the complaint. The parties will be provided with an opportunity to speak at the HCSB meeting and provide more detailed information regarding the complaint allegations. Following the hearing and review, the HCSB will inform the parties in writing of the action that has been taken with respect to the complaint. Where the Board finds a pattern of abuse, it refers its findings to the appropriate board of registration.

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.

Contact for Health care provider complaint

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