CHC Fact Sheet on Complaints and Grievances Issued

Community HealthChoices (CHC) is Pennsylvania’s mandatory managed care program for individuals who are dually eligible for Medicare and Medicaid, and individuals 21 years of age or older with physical disabilities who receive long-term services and supports through Medicaid. CHC is currently live in the Southwest and Southeast part of the state. The remainder of the state will transition to CHC on January 1, 2020.

CHC participants have protections if they do not agree with a CHC managed care organization’s (CHC-MCO’s) decision to deny, decrease, or approve a service or item different from what was requested. Participants can also voice dissatisfaction with their CHC-MCO or a provider. These concerns or issues can be voiced through the complaints and grievance process. Information about the complaint and grievance process is available in this fact sheet. Additional information is provided in a comprehensive FAQ Document. For additional questions, please visit the CHC website or submit via email.