TMPPM 2008 > Provider Information > Managed Care > Medicaid Managed Care

7.1.8 Medicaid Managed Care Complaints and Fair Hearings

Medicaid Managed Care providers may file complaints with HHSC if they find they did not receive full due process from the respective managed care health plan.

Appeals/grievances or dispute resolution is the responsibility of each managed care health plan or PCCM. Providers must exhaust the complaints/grievance process with their managed care health plan or PCCM before filing a complaint with HHSC.

Please refer to the respective health plan or PCCM for information about specific complaint policies and procedures. For PCCM, please see "Provider Complaints and Appeals" . For NorthSTAR, see "Complaints and Appeals" . For HMOs, refer to the respective health plan's policies and procedures.