Consumer Grievance Policy
Complaints and grievances regarding program and services or access to health care services for enrolled consumers are to be directed to the appropriate State office. If a HealthCare Access Maryland (HCAM) consumer has a concern, unanswered question, or complaint regarding his/her treatment or quality of service delivered by HCAM, the consumer may exercise his/her right to file a grievance by following the steps below.
Step 1: The consumer should first address their question, concern, complaint, or grievance to the person perceived as the source of the confusion or conflict. It is anticipated that most conflict will be resolved in this step. If not resolved by direct communication at the source of the problem, or if the consumer does not wish to address the other person involved, he/she may proceed to step 2.
Step 2: The consumer may consult the HCAM employee’s direct supervisor, explain the conflict, and solicit the Vice President of Administration’s (VP Admin) intervention as a conflict resolution mediator. It is the duty of the VP Admin to inform all involved parties of the conflict, collect information, conduct an investigation, conduct interviews, and help facilitate a mutually agreeable resolution. If the consumer wishes to remain anonymous or to appoint a representative as his/her spokesperson or advocate, the VP Admin should accommodate and protect the wishes of the consumer. The consumer may request a meeting of all involved parties and solicit the assistance of the Departmental Supervisor and VP Admin as a mediator. A mutually agreed upon neutral party may also serve as a mediator. Notes of this meeting should be taken for documentation purposes.
Step 3: The consumer may choose to bypass steps 1 and 2 and initiate a grievance directly to HCAM’s President. This step may be taken with or without the knowledge of the staff involved in the grievance. The grievance may be communicated by telephone or letter. A letter is preferred for the purpose of clear understanding. (If the consumer wishes to maintain anonymity, it should be approached with the understanding that a full investigation may not be achieved.) Grievances should be addressed to:
HealthCare Access Maryland, Inc.
1 N Charles Street, Suite 900
Baltimore, MD 21201
When a grievance is received in the President’s office, written notification must be sent to the complainant within 15 calendar days. It is incumbent upon the President, the VP Admin, or the Departmental Supervisor to conduct a professional, impartial, timely, and thorough investigation within 30 days. A letter detailing the findings of the investigation and any action to be taken by HCAM will be generated and sent to the consumer at the conclusion of all investigative activities.