Federal Oversight
The agencies responsible for your care.
Mailing Address
7500 Security Boulevard
Baltimore, MD 21244
Baltimore, MD 21244
Media Inquiries
Media Line
Civil Rights Office (OCR)
1-800-368-1019
Discrimination complaints, ADA violations, HIPAA
Discrimination complaints, ADA violations, HIPAA
OCR Complaint Portal
ADA / Civil Rights
Mailing Address
200 Independence Avenue SW
Washington, DC 20201
Washington, DC 20201
Media / Press
Press Office
Mailing Address
P.O. Box 23489
Washington, DC 20026
Washington, DC 20026
Key Use Case
ESRD facility non-compliance, improper discharge, billing fraud, retaliation
Transplant Issues / OPTN Oversight
Division of Transplantation
5600 Fishers Lane
Rockville, MD 20857
Transplant Authority
Rockville, MD 20857
File ADA Complaint Online
Civil Rights Complaints
Disability Rights Section
950 Pennsylvania Ave NW
Washington, DC 20530
Washington, DC 20530
Key Statutes
Americans with Disabilities Act (ADA) · Section 504 · Section 508 · Fair Housing Act
FraudNet Online
Congressional Requests
Complaints referred to relevant committee staff for GAO investigation
Congress
The legislators who set the rules.
Committee Main
Majority Staff Director
Senate Finance Committee
219 Dirksen Senate Office Building
Washington, DC 20510
219 Dirksen Senate Office Building
Washington, DC 20510
Committee Website
Hearing Schedule
Key Committee — Kidney Policy
Submit Public Comment
Contact committee staff directly. Reference ESRD/transplant policy by bill number or docket for fastest routing.
Committee Website
Relevance
HRSA oversight, transplant safety regulation, organ procurement reform
Committee Website
Health Subcommittee
Primary House oversight of Medicare, Medicaid, OPTN, ESRD policy. File constituent concerns through your House member.
OPTN Reform Jurisdiction
Committee Website
Relevance
ESRD bundled payment reform, dialysis center reimbursement, Medicare funding for transplant
Transplant System
The organizations that control the list.
Find Your ESRD Network
Network 7 (SE United States / Florida)
File Grievance Here First
What They Handle
Discharge disputes · Facility complaints · Patient rights violations · 42 CFR §494 complaints
Timeline
Network must acknowledge complaint within 3 business days. Resolution target: 30 days.
CMS ESRD Network Oversight
All 18 Networks Directory
Main Number
Complaints About OPO Conduct
File with HRSA Division of Transplantation AND your regional OPTN member organization simultaneously.
State Level
State survey agencies & Medicaid offices.
Click any state to view contact information
Not selected
Selected
Universal: For any state, your State Survey Agency handles complaints against Medicare/Medicaid-certified facilities including dialysis centers. Find yours at:
cms.gov State Survey Agency Map →
|
Medicare Care Compare (facility ratings) →
Legal Framework
The laws that protect you.
DOJ ADA Hotline
File Complaint Online
Primary ADA Enforcement
What It Covers
Title II: State and local government services
Title III: Places of public accommodation including medical offices, dialysis centers, transplant centers
Title III: Places of public accommodation including medical offices, dialysis centers, transplant centers
Key Provisions for Care Partners
Reasonable accommodation requests · Accompaniment rights · Communication access · Physical access requirements
Who It Applies To
Any entity receiving federal financial assistance — this includes every dialysis center, transplant center, and hospital that accepts Medicare or Medicaid.
Statute Reference
29 U.S.C. § 794
45 CFR Part 84 (HHS implementation)
45 CFR Part 84 (HHS implementation)
Care Partner Rights
With patient authorization, care partners have right to access records, receive information, and be present during care discussions. Facilities cannot deny access without documented clinical justification.
Key CFR Citation
45 CFR §164.524 (access to records)
45 CFR §164.510 (care partner disclosures)
45 CFR §164.510 (care partner disclosures)
Key Rights Under 42 CFR §494.70
Right to be informed · Right to participate in care planning · Right to file grievance without retaliation · Right to adequate notice before discharge · Right to access records
Legally Enforceable
Discharge Protections — 42 CFR §494.180
Facility cannot discharge without adequate written notice. Must ensure continuity of care during transition. Discharge cannot be used as retaliation for exercising rights.
Enforce Via
1. Your ESRD Network (grievance)
2. Your State Survey Agency
3. CMS Regional Office
4. OIG (if retaliation involved)
2. Your State Survey Agency
3. CMS Regional Office
4. OIG (if retaliation involved)
Lean Six Sigma · Accountability Dashboard
Escalation priority by severity and impact.
Critical
4
Immediate escalation required
High
6
File within 72 hours
Medium
5
File within 30 days
Low
3
Document and monitor
Complaint Escalation Matrix — Where to File & When
| Priority | Issue | File With | CFR / Statute | Timeline | Impact Score |
|---|---|---|---|---|---|
| Critical | Facility threatens/executes discharge in retaliation for complaint | ESRD Network (same day) + OIG + State Survey Agency | 42 CFR §494.180, §494.70(f) | File within 24 hours | |
| Critical | Denial of scheduled dialysis treatment without medical justification | 1-800-MEDICARE + State Survey Agency immediately | 42 CFR §494.180(b) | File same day | |
| Critical | Transplant center removes patient from waiting list without due process | UNOS Patient Services + HRSA Division of Transplantation + your transplant attorney | OPTN Policy 18 · 42 CFR §121 | File within 48 hours | |
| Critical | Disability discrimination in healthcare setting | HHS OCR + DOJ ADA Hotline | ADA Title III · Section 504 · 45 CFR §84 | File within 180 days | |
| High | Facility refuses to provide records or denies care partner access | HHS OCR (HIPAA complaint) | 45 CFR §164.524 | File within 180 days | |
| High | Chronic understaffing or unsafe patient-to-staff ratios | State Survey Agency + ESRD Network | 42 CFR §494.140 | File within 72 hours | |
| High | Billing fraud, upcoding, improper Medicare charges | OIG Hotline: 1-800-447-7660 | 42 U.S.C. §1320a-7b (Anti-kickback) | File as discovered | |
| High | Excluded from patient care planning without justification | ESRD Network grievance | 42 CFR §494.70(a)(2) | File within 30 days | |
| Medium | Facility fails to respond to internal grievance within required timeframe | ESRD Network escalation | 42 CFR §494.70(f)(4) | File after 30 days non-response | |
| Medium | Failure to obtain informed consent or provide adequate information | State licensing board + ESRD Network | 42 CFR §494.70(a)(5) | File within 60 days | |
| Medium | Concern about organ allocation decision process | UNOS Patient Services + HRSA | OPTN Policy · 42 CFR §121.4 | File within 90 days | |
| Low | Inaccurate documentation in medical records | HHS OCR + facility compliance officer | 45 CFR §164.526 | File within 180 days |
LSS Methodology Note
Impact scores calculated using a modified FMEA (Failure Mode & Effects Analysis) framework: Severity × Occurrence × Detectability. Critical items (≥9.0) represent failures with immediate patient safety implications. File simultaneously with all listed agencies for maximum accountability pressure. Use the Situation Room to generate exact complaint language with CFR citations.