You have the right to file a complaint if you believe your therapist or any healthcare provider has violated your privacy or security rights. This document explains everything you need to know about filing a complaint about a healthcare provider. It explains how to file a complaint, who you can file a complaint about, what you can file a complaint about, who to file the complaint with and where to send your complaint.
Before filing a complaint, please discuss your complaint with your healthcare provider. Your provider may be unaware that you have a complaint and may be able to resolve your issue.
If your issue is not resolved, you can file a complaint to the U.S. Dept. of Health and Human Services. You can find more information about filing a complaint at the U.S. Department of Health and Human Services website.
What You Need to Know Before Filing a Complaint
- This is an official complaint with the U.S. government and should not be taken lightly.
- By filing a complaint, you will be signing a official document, where you must be completely honest.
- You can be prosecuted for falsifying information, exaggerating or lying in your complaint.
- Your complaint will be officially investigated by the federal government.
- You can only file a complaint if your civil rights were violated.
I want to make it clear that filing a complaint is serious. You can’t file a complaint just because your provider made you mad. You can’t complain because your provider charged you a fee for missing an appointment. You can’t do it because your provider wouldn’t do something you wanted like provide a letter for a Suboxone clinic. This is only for violations of your civil rights.
At the same time, I don’t want to discourage you if you rights were truly violated. I included this information because I know that healthcare providers do violate people’s rights sometimes. And most people aren’t even aware they can file a complaint.
Who Can You File a Complaint About
- Professional Counselors
- Social Workers
- Marriage and Family Therapists
- Nursing Homes
- Health Insurance Companies
- Company Health Plans
- Medicare, Medicaid, and other government programs that pay for health care
You can file a complaint about most healthcare providers. The complaint has to be about a “covered entity” who has to comply with the HIPAA Privacy and Security Rules. “Covered entities” are health plans, health care clearinghouses, and health care providers who electronically transmit any health information.
What Can You File a Complaint About
- Your HIPAA rights were violated.
What does this mean? Your privacy rights could be violated if your healthcare provider shared your protected health information without your consent. An example of this is if your doctor tells your family or friends about your medical condition or medications you take without your consent. But there are exceptions to this rule. A doctor can talk to your family if you are incapacitated and she believes you would want her to share this information to save your life. Providers can share information if you are a danger to yourself or others. And providers have to share information if a child or elderly person is abused.
Another thing you can file a complaint about is if your protected health information was vulnerable because your provider didn’t follow HIPAA standards for electronic transmission of health information. An example of this is if your provider doesn’t password protect or encrypt your health information or there is a breach where your information could be viewed by a third-party.
This infographic explains what your rights are. If any of these rights were violated, you can file a complaint.
How to File Your Complaint
- Your complaint must be in writing.
- You have 180 days to file a complaint although the time can be extended if you have good cause.
- Your provider cannot retaliate if you file a complaint.
- You can file a complaint by mail, email, online or fax.
- Send your complaint to the U.S. Dept. of Health and Human Services or one of their regional offices.
- You can write your own complaint or use a Health Information Privacy Complaint Package.
Information to Include in Your Complaint
Include your name, address, phone number and email address. Include the name, address and phone number of the person or business involved. Write a brief description of how your rights were violated. Sign and date your complaint.
- You must name the person or business involved in the complaint.
- Include the details of your complaint
- Explain how your provider violated your rights
File a Complaint by Mail
Mail your complaint to:
Centralized Case Management Operations
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Room 509F HHH Bldg.
Washington, D.C. 20201
File a Complaint by Email
You can email your complaint to OCRComplaint@hhs.gov. There is a risk that unencrypted email could be intercepted.
File a Complaint Online
You can file your complaint online through the OCR Complaint Portal.
File a Complaint Through a Regional Office
You can mail or fax your complaint to the regional office closest to the place where the violation happened. Find the contact information for your regional office at this link.