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Discrimination Complaint Procedure

Section 1557 of the Affordable Care Act (ACA) prohibits discrimination in health care programs and activities that get money from the federal government.

It is against the law for MassHealth to discriminate against you or treat you unfairly based on your race, color, national origin, age, disability, religion, creed, sexual orientation, or sex (including gender identity and gender stereotyping).

If you believe that you have been treated unfairly for any of these reasons, you may submit a complaint (also known as a grievance).  It is against the law for MassHealth to retaliate against anyone who reports discrimination, submits a complaint, or takes part in the investigation of a complaint.

What should I do if I have a complaint?

MassHealth has someone called a “Compliance Coordinator” to help you with your complaint. 

If you wish to submit a complaint, you must do so within 60 days of the date on which you believe the unfair treatment occurred.

To submit a complaint:

  1. Fill out the "Discrimination Complaint Form"
  2. Send the form to:

         Mail: Section 1557 Compliance Coordinator
                  1 Ashburton Place, 11th Floor
                  Boston, MA 02108.

         Fax: (617) 889-7862, or

         EmailSection1557Coordinator@state.ma.us.

  1. For help, call the Compliance Coordinator at (617) 573-1704 (TTY: (617) 573-1696).

Additional Resources for What should I do if I have a complaint?

What will the Compliance Coordinator do with my complaint?

  • Your complaint will be investigated.
  • The Compliance Coordinator will only share your file with people who need to know about the case.
  • The Compliance Coordinator will then send you a written decision within 60 days of receiving the complaint.
  • The Compliance Coordinator will also tell you if more information is needed to complete the investigation.

If I do not agree with the Compliance Coordinator’s decision, can I appeal?

  • Yes, an appeal form will be included with the Compliance Coordinator’s decision.
  • To appeal, you must submit the appeal form within 30 days of receiving the Compliance Coordinator’s decision to the Assistant Secretary for MassHealth.
    • Send your appeal to:

                  Assistant Secretary for MassHealth
                  1 Ashburton Place, 11th Floor
                  Boston, MA 02108.

                  Fax: (617) 889-7862, or

                  Email: Section1557Coordinator@state.ma.us.

  • For help with an appeal, call the Compliance Coordinator at (617) 573-1704 (TTY: (617) 573-1696).
  • The Assistant Secretary for MassHealth will respond in 60 days from the date on which your appeal was received.

 

What other options do I have?

  • You also have other options for filing a complaint. For example:
    • You may file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights (HHS OCR). You may file a complaint with the HHS OCR in the following ways:

                       U.S. Department of Health and Human Services
                       200 Independence Avenue SW
                       Room 509F, HHH Building
                       Washington, DC 20201.

  • HHS OCR Complaint forms are available at www.hhs.gov/ocr/office/file/index.html.
  • HSS OCR complaints must be filed within 180 days of the date of the alleged discrimination.
  • You may also file a complaint in court.

What if I need help?

  • If you are disabled or have limited English language abilities, MassHealth can help you.
  • For example, MassHealth has aids and services available to assist you including: qualified interpreters, taped cassettes of material for individuals with low vision, and a barrier-free location for the proceedings.
  • If you need any of these arrangements, please contact the Compliance Coordinator at (617) 573-1704, TTY: (617) 573-1696, fax: (617) 889-7862, or email: Section1557Coordinator@state.ma.us

What if I want to learn more about this process?

To learn more about Section 1557 of the ACA (42 U.S.C. 18116) and its implementing regulations at 45 CFR part 92, issued by the U.S. Department of Health and Human Services, you can examine them in the office of the Section 1557 Compliance Coordinator. Contact the Compliance Coordinator at the address, fax, email, or phone number above.

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