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Managed Care

The Department of Health reviews, approves, licenses and monitors the quality of care provided to consumers by health maintenance organizations (HMOs) and other managed care systems.  The department promotes innovation in the health care marketplace by encouraging the development of alternative health delivery systems.  It identifies problems associated with cost, quality and access within the managed care industry and initiates solutions with consumers and providers.

The department also administers a consumer grievance program and ensures that each licensed HMO has an approved process in place to handle member complaints and grievances.  When an HMO member is dissatisfied with the way their insurer has handled their complaint or grievance, a toll-free number, answered by Department of Health staff is available to provide additional information and/or assist them in obtaining resolution.


Contact Information

Bureau of Managed Care
Room 912 Health & Welfare Building
625 Forster Street
Harrisburg, Pennsylvania 17120-0701
(717-787-5193 or toll-free 1-888-466-2787