File a HIPAA-related complaint
Use the Health Insurance Portability and Accountability Act (HIPAA) Complaint form to inform the AMA about health insurers and other payers that are out of compliance with the HIPAA electronic transaction and code set standards.
Please read the following information and scroll down to access the AMA complaint form to file a HIPAA-related complaint
Please be aware that completing this form does not constitute filing a complaint with Centers for Medicaid and Medicare Services (CMS). If you wish to file a complaint with the CMS, you may do so on the CMS website. If you wish to file a complaint with the Department of Health and Human Services (HHS), you may do so on the HHS website.
All public and private payers and clearinghouses must be able to handle all mandated electronic transactions in HIPAA-compliant electronic formats. This includes claims and electronic remittance advice, claims status, eligibility, referral certification and prior authorization transactions. Automation of the physician practice is dependent on payer compliance with these standards, so please help us eliminate administrative waste and report problems related to HIPAA compliance on this complaint form. Completion of the form is voluntary and confidential.
Please do not include any "Protected Health Information" (PHI) about any of your patients on the complaint form.
The AMA intends to share aggregated information with CMS, the agency responsible for enforcing the HIPAA electronic transaction and code set requirements. CMS may use data to help guide its enforcement actions. The AMA will use the data to keep AMA leaders, members, medical societies, the media and other interested parties abreast of HIPAA compliance issues and to advocate on the behalf of physicians.
Additionally, the AMA may pursue compliance activities with individual plans, payers or clearinghouses where a pattern of complaints warrants. Since the form is filled out anonymously, neither the AMA nor CMS will respond to individual complainants