Complaints about STAR and STAR+PLUS plans
The charts below show justified complaints for Medicaid health plans from Sept. 1, 2008, to Aug. 31, 2009. Justified complaints are those where the Texas Health and Human Services Commission (HHSC) investigated, confirmed there was a problem, and took action to fix it.
Use the list on the left to see charts for the different health plans. The charts include:
- Plan name — The health plan named in the complaint.
- Program type — The Medicaid managed care network in which the health plan provides services.
- Service area — The part of the state the Medicaid managed care network covers.
- Nature of issue — What the complaint was about.
Click here to see examples of complaints filed by people with Medicaid or Medicaid providers.
Click here for a PDF file with all of the plan information.
Complaints about Amerigroup Texas, Inc. from Sept. 1, 2008, to Aug. 31, 2009
| Service Area |
Program Type |
Nature Of Issue |
| Dallas |
STAR |
A01-ACCESS TO CARE |
| Harris |
STAR |
A01-ACCESS TO CARE |
| Harris |
STAR |
A01-ACCESS TO CARE |
| Harris |
STAR |
A01-ACCESS TO CARE |
| Harris |
STAR |
A35-INCORRECT RECIPIENT INFO/ELIGIBILITY |
| Tarrant |
STAR |
A01-ACCESS TO CARE |
| Bexar |
STAR+PLUS |
A56-PCP SELECTION OR TURNOVER |
| Bexar |
STAR+PLUS |
A57-PROVIDER ABUSE OR NEGLECT |
| Bexar |
STAR+PLUS |
A57-PROVIDER ABUSE OR NEGLECT |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A02-BENEFIT ISSUES |
| Harris |
STAR+PLUS |
A05-COORDINATION OF BENEFITS |
| Harris |
STAR+PLUS |
A05-COORDINATION OF BENEFITS |
| Harris |
STAR+PLUS |
A05-COORDINATION OF BENEFITS |
| Harris |
STAR+PLUS |
A09-DURABLE MEDICAL EQUIPMENT (DME) |
| Harris |
STAR+PLUS |
A09-DURABLE MEDICAL EQUIPMENT (DME) |
| Harris |
STAR+PLUS |
A09-DURABLE MEDICAL EQUIPMENT (DME) |
| Harris |
STAR+PLUS |
A39-PAYMENT DISPUTE |
| Harris |
STAR+PLUS |
A57-PROVIDER ABUSE OR NEGLECT |
| Harris |
STAR+PLUS |
A57-PROVIDER ABUSE OR NEGLECT |
| Travis |
STAR+PLUS |
A01-ACCESS TO CARE |
| Travis |
STAR+PLUS |
A01-ACCESS TO CARE |
| Travis |
STAR+PLUS |
A05-COORDINATION OF BENEFITS |
| Travis |
STAR+PLUS |
A09-DURABLE MEDICAL EQUIPMENT (DME) |
| Travis |
STAR+PLUS |
A57-PROVIDER ABUSE OR NEGLECT |
| Travis |
STAR+PLUS |
A57-PROVIDER ABUSE OR NEGLECT |
top of page
Complaints about Community First from Sept. 1, 2008, to Aug. 31, 2009
| Service Area |
Program Type |
Nature Of Issue |
| Bexar |
STAR |
A01.1-MEMBER CLAIM/BILLING ISSUE |
Complaints about Community Health Choice from Sept. 1, 2008, to Aug. 31, 2009
| Service Area |
Program Type |
Nature Of Issue |
| Harris Exp. |
STAR |
A20-OUT OF NETWORK REFERRAL |
top of page
Complaints about Evercare from Sept. 1, 2008, to Aug. 31, 2009
| Service Area |
Program Type |
Nature Of Issue |
| Nueces |
STAR |
A93-ENROLLMENT/CANCELATION/RENEWAL OF ENROLLEE |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A05-COORDINATION OF BENEFITS |
| Harris |
STAR+PLUS |
A09-DURABLE MEDICAL EQUIPMENT (DME) |
| Harris |
STAR+PLUS |
A09-DURABLE MEDICAL EQUIPMENT (DME) |
| Harris |
STAR+PLUS |
A09-DURABLE MEDICAL EQUIPMENT (DME) |
| Harris |
STAR+PLUS |
A09-DURABLE MEDICAL EQUIPMENT (DME) |
| Harris |
STAR+PLUS |
A09-DURABLE MEDICAL EQUIPMENT (DME) |
| Harris |
STAR+PLUS |
A09-DURABLE MEDICAL EQUIPMENT (DME) |
| Harris |
STAR+PLUS |
A09-DURABLE MEDICAL EQUIPMENT (DME) |
| Harris |
STAR+PLUS |
A09-DURABLE MEDICAL EQUIPMENT (DME) |
| Harris |
STAR+PLUS |
A36-MCO / PROVIDER CONTRACT - OTHER |
| Harris |
STAR+PLUS |
A57-PROVIDER ABUSE OR NEGLECT |
| Harris |
STAR+PLUS |
A57-PROVIDER ABUSE OR NEGLECT |
| Harris |
STAR+PLUS |
A57-PROVIDER ABUSE OR NEGLECT |
| Harris |
STAR+PLUS |
A57-PROVIDER ABUSE OR NEGLECT |
| Harris Exp. |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris Exp. |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris Exp. |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris Exp. |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris Exp. |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris Exp. |
STAR+PLUS |
A01.1-MEMBER CLAIM/BILLING ISSUE |
| Harris Exp. |
STAR+PLUS |
A02-BENEFIT ISSUES |
| Harris Exp. |
STAR+PLUS |
A05-COORDINATION OF BENEFITS |
| Harris Exp. |
STAR+PLUS |
A57-PROVIDER ABUSE OR NEGLECT |
| Nueces |
STAR+PLUS |
A01-ACCESS TO CARE |
| Nueces |
STAR+PLUS |
A01-ACCESS TO CARE |
| Nueces |
STAR+PLUS |
A01-ACCESS TO CARE |
| Nueces |
STAR+PLUS |
A01-ACCESS TO CARE |
| Nueces |
STAR+PLUS |
A01-ACCESS TO CARE |
| Nueces |
STAR+PLUS |
A02-BENEFIT ISSUES |
| Nueces |
STAR+PLUS |
A02-BENEFIT ISSUES |
| Nueces |
STAR+PLUS |
A05-COORDINATION OF BENEFITS |
| Nueces |
STAR+PLUS |
A57-PROVIDER ABUSE OR NEGLECT |
| Nueces |
STAR+PLUS |
A93-ENROLLMENT/CANCELATION/RENEWAL OF ENROLLEE |
| Nueces |
STAR+PLUS |
A93-ENROLLMENT/CANCELATION/RENEWAL OF ENROLLEE |
| Nueces |
STAR+PLUS |
A93-ENROLLMENT/CANCELATION/RENEWAL OF ENROLLEE |
| Nueces |
STAR+PLUS |
A93-ENROLLMENT/CANCELATION/RENEWAL OF ENROLLEE |
| Nueces |
STAR+PLUS |
A93-ENROLLMENT/CANCELATION/RENEWAL OF ENROLLEE |
| Nueces |
STAR+PLUS |
A93-ENROLLMENT/CANCELATION/RENEWAL OF ENROLLEE |
| Nueces |
STAR+PLUS |
A93-ENROLLMENT/CANCELATION/RENEWAL OF ENROLLEE |
| Nueces |
STAR+PLUS |
A93-ENROLLMENT/CANCELATION/RENEWAL OF ENROLLEE |
| Nueces |
STAR+PLUS |
A93-ENROLLMENT/CANCELATION/RENEWAL OF ENROLLEE |
| Nueces |
STAR+PLUS |
A93-ENROLLMENT/CANCELATION/RENEWAL OF ENROLLEE |
| Nueces |
STAR+PLUS |
A93-ENROLLMENT/CANCELATION/RENEWAL OF ENROLLEE |
| Travis |
STAR+PLUS |
A01-ACCESS TO CARE |
| Travis |
STAR+PLUS |
A01-ACCESS TO CARE |
| Travis |
STAR+PLUS |
A01-ACCESS TO CARE |
| Travis |
STAR+PLUS |
A01-ACCESS TO CARE |
| Travis |
STAR+PLUS |
A01-ACCESS TO CARE |
| Travis |
STAR+PLUS |
A01-ACCESS TO CARE |
| Travis |
STAR+PLUS |
A09-DURABLE MEDICAL EQUIPMENT (DME) |
| Travis |
STAR+PLUS |
A09-DURABLE MEDICAL EQUIPMENT (DME) |
| Travis |
STAR+PLUS |
A09-DURABLE MEDICAL EQUIPMENT (DME) |
| Travis |
STAR+PLUS |
A57-PROVIDER ABUSE OR NEGLECT |
| Travis |
STAR+PLUS |
A93-ENROLLMENT/CANCELATION/RENEWAL OF ENROLLEE |
| Travis |
STAR+PLUS |
A93-ENROLLMENT/CANCELATION/RENEWAL OF ENROLLEE |
top of page
Complaints about Molina Healthcare of Texas from Sept. 1, 2008, to Aug. 31, 2009
| Service Area |
Program Type |
Nature Of Issue |
| Bexar |
STAR+PLUS |
A01-ACCESS TO CARE |
| Bexar |
STAR+PLUS |
A05-COORDINATION OF BENEFITS |
| Bexar |
STAR+PLUS |
A57-PROVIDER ABUSE OR NEGLECT |
| Bexar |
STAR+PLUS |
A57-PROVIDER ABUSE OR NEGLECT |
| Harris |
STAR+PLUS |
A01-ACCESS TO CARE |
| Harris |
STAR+PLUS |
A33-DENIAL OF CLAIM |
Complaints about Parkland Community Health Plan from Sept. 1, 2008, to Aug. 31, 2009
| Service Area |
Program Type |
Nature Of Issue |
| Dallas |
STAR |
A01.1-MEMBER CLAIM/BILLING ISSUE |
| Dallas |
STAR |
A71-DELAY OF REFERRAL OR AUTHORIZATION |
top of page
Complaints about Superior Health Plan, Inc. from Sept. 1, 2008, to Aug. 31, 2009
| Service Area |
Program Type |
Nature Of Issue |
| Travis |
STAR |
A01-ACCESS TO CARE |
| Travis |
STAR |
A01-ACCESS TO CARE |
| EL Paso |
STAR |
A83-DENIAL OF AUTHORIZATION OF CARE |
| Bexar |
STAR+PLUS |
A01-ACCESS TO CARE |
| Bexar |
STAR+PLUS |
A01-ACCESS TO CARE |
| Bexar |
STAR+PLUS |
A01-ACCESS TO CARE |
| Bexar |
STAR+PLUS |
A01-ACCESS TO CARE |
| Bexar |
STAR+PLUS |
A01-ACCESS TO CARE |
| Bexar |
STAR+PLUS |
A01-ACCESS TO CARE |
| Bexar |
STAR+PLUS |
A06-CUSTOMER SERVICE |
| Bexar |
STAR+PLUS |
A09-DURABLE MEDICAL EQUIPMENT (DME) |
| Bexar |
STAR+PLUS |
A39-PAYMENT DISPUTE |
| Bexar |
STAR+PLUS |
A73-IN NETWORK: SPECIALTY CARE/PROVIDER ACCESS |
| Bexar |
STAR+PLUS |
A84-DENIAL/NON-PAYMENT MN DME/SUPPLIES |
| Nueces |
STAR+PLUS |
A01-ACCESS TO CARE |
Complaints about Texas Childrens Health Plan from Sept. 1, 2008, to Aug. 31, 2009
| Service Area |
Program Type |
Nature Of Issue |
| Harris |
STAR |
A01-ACCESS TO CARE |
| Harris |
STAR |
A01-ACCESS TO CARE |
| Harris |
STAR |
A76-PCP SELECTION |
top of page
Complaints about United Healthcare of Texas from Sept. 1, 2008, to Aug. 31, 2009
| Service Area |
Program Type |
Nature Of Issue |
| Harris |
STAR |
A09-DURABLE MEDICAL EQUIPMENT (DME) |
| Harris |
STAR |
A01-ACCESS TO CARE |
top of page
Examples of complaints filed by people with Medicaid or Medicaid providers
| Nature of issue |
Example of complaint |
| A01.1-MEMBER CLAIM/BILLING ISSUE |
Person got a bill for services that should be paid by Medicaid |
| A01-ACCESS TO CARE |
Took too long for person to see a health care provider or did not receive the right services. |
| A02-BENEFIT ISSUES |
Person couldn't get a certain health care service. |
| A05-COORDINATION OF BENEFITS |
Person not satisfied with Medicaid services offered by the health plan. |
| A06-CUSTOMER SERVICE |
Person not happy with a provider or health plan's customer service. |
| A09-DURABLE MEDICAL EQUIPMENT (DME) |
Person had problems getting equipment or supplies like wheelchairs, adult diapers, or other things. |
| A20-OUT OF NETWORK REFERRAL |
Person couldn't get approval to receive services outside the managed care network. This could also be a complaint from a doctor, nurse, or clinic. |
| A33-DENIAL OF CLAIM |
Provider had an issue with getting paid for a claim. |
| A35-INCORRECT RECIPIENT INFO/ELIGIBILITY |
Provider didn't have the right information about a person's Medicaid coverage. |
| A36-MCO / PROVIDER CONTRACT – OTHER |
Person had a problem with a home health provider, primary care doctor, or other provider. |
| A39-PAYMENT DISPUTE |
Provider had an issue with getting paid for a claim. |
| A56-PCP SELECTION OR TURNOVER |
Person needed help finding a primary care provider (main doctor). |
| A57-PROVIDER ABUSE OR NEGLECT |
Person reported abuse or neglect by a provider. |
| A71-DELAY OF REFERRAL OR AUTHORIZATION |
A health plan took too long to respond to a request for a service to be approved. |
| A73-IN NETWORK: SPECIALTY CARE/PROVIDER ACCESS |
Person needed a specific provider for specialized medical care. |
| A76-PCP SELECTION |
Person needed help finding a primary care provider (main doctor). |
| A83-DENIAL OF AUTHORIZATION OF CARE |
Provider had an issue with getting paid for a claim because it was not approved in advance. |
| A84-DENIAL/NON-PAYMENT MN DME/SUPPLIES |
Person had an issue with getting equipment or supplies. Or, provider had an issue with getting paid for a claim because it was not approved in advance. |
| A93-ENROLLMENT/CANCELATION/RENEWAL OF ENROLLEE |
Person was no longer in the managed care network. |
top of page
Updated:
July 10, 2012
