• How to navigate CMS’ new process for filing Medicare Advantage complaints

    The Centers for Medicare & Medicaid Services (CMS) has announced a new online form to submit complaints about Medicare Advantage (MA) plans.

    How to access the complaint form

    To access the online complaint form, perform the following steps:

    • Go to CMS.gov,
    • Select “Medicare” from the top-left dropdown menu,
    • Select “Health & drug plans” from the left-hand navigation,
    • Select “Report a provider complaint about an MA plan.”

    Information collected

    The online form requires the following:

    • Basic information about the complainant,
    • Beneficiary name and identifying number,
    • "Provider" name and contact info,
    • Medicare Advantage plan information,
    • A summary of the complaint.

    The form also includes optional fields for dates of service and claim number. Because complaint information is now collected through the online form, MA plans will no longer receive an attachment of the original provider complaint form.

    Additional details

    Complaints submitted through the form are routed to the Health Plan Management System (HPMS) Complaints Tracking Module. After the complaint is placed into the tracking module’s queue, CMS reviews it, triages it, and assigns it a contract number.

    Practices should first exhaust an MA plan’s standard appeals process before using CMS’ online complaint form, unless they are reporting an ongoing, systemic issue that the MA plan has not resolved.

    The American Academy of Family Physicians is working to gather additional information regarding the new process and will update this post as further details become available.

    — Brennan Cantrell, AAFP Senior Strategist, Market Transformation

    Posted on March 5, 2026



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