Medicare Beneficiaries Masspro has been the federally-designated Quality Improvement Organization (QIO) for Massachusetts since 1986. Our goal is to improve the quality of health care provided to Medicare beneficiaries and to help protect their Medicare rights. If you have Medicare coverage, Masspro is your access to
Filing a concern about the quality of health care you or a loved one received in the past or are receiving now
Appealing a notice that the hospital intends to send you home when you believe you should continue to stay
Appealing a notice that states a course of treatment (such as rehabilitation, nursing home, home health or hospice care) is going to end when you believe you still need those services
We offer a helpline, 1-800-252-5533, where beneficiaries can begin the appeals process, report a quality of care complaint, or get help finding other helpful resources.
Appointment of Representative As a Medicare beneficiary, you may need someone to act on your behalf with your appeal or quality of care concern. That person would be your appointed representative, as described in the Code of Federal Regulations, 42 CFR section 405.910(a).
There is an official form (CMS-1696) you must fill out to authorize that person to act on your behalf. The form is called the Appointment of Representative. This form must be signed by the beneficiary identifying the appointed representative and returned to Masspro before we can proceed with the quality of care review process. Click here to see the Appointment of Representative form and print it.
MassHealth Members and Applicants
To ensure that MassHealth members and applicants can easily locate the information they need, Masspro is pleased to provide the following telephone numbers and Web links:
MassHealth Customer Service Center- for member questions and concerns
(P) 1-800-841-2900
(TTY) 1-800-497-4648 (for persons with partial or total hearing loss)
MassHealth Enrollment Center- for questions regarding MassHealth eligibility
(P) 1-888-665-9993
(TTY) 1-888-665-9997 (for persons with partial or total hearing loss)
Find more health care information by clicking here.
Consumer Feedback
If you have a comment, complaint, compliment or request for Masspro, please complete a Consumer Feedback Form or dial the operator at 781-890-0011 during normal business hours (8:00 am-5:00 pm, Monday-Friday).
