HMO Complaints and Appeals: Plans' Systems Have Most Key Elements, but Consumer Concerns Remain

GAO discussed its recent report on health maintenance organization (HMO) complaint and appeal procedures, focusing on: (1) the elements that are considered important to a system for processing HMO members' complaints and appeals; (2) the extent to which HMOs' complaint and appeal systems for members contain these elements; (3) the concerns that consumers have regarding HMO complaint and appeals systems; (4) the information that is available on the number and types of complaints and appeals HMOs receive from their members; and (5) how, if at all, HMOs use their complaint and appeal data.