Ombudsman Complaint Process

The Office of the Ombudsman helps resolve complaints regarding health and human services when a program's complaint process cannot or does not resolve the issue.

If you have a complaint, we encourage you to first discuss it with the specific person, program or office involved. Many times, they can explain a policy or correct the problem immediately.

Frequently requested contacts:

How we help you:

When you contact us, here is what you can expect:

  • We will follow the Texas HHS customer service principles.
  • We will explain our process and ask if you want us to call or write you with updates. We will also provide you a timeline of how long our work might take.
  • We arrange translation services to help us communicate with you, if necessary.
  • Before asking others to look into your concern, we will research your case using information from our agency.
  • If we cannot help you, we will refer you to the proper contact.
  • Your request will be saved in our records, and you will probably be asked questions to confirm your identity. We will ask if it is OK before we share your information with anyone that does not work for Texas HHS.

A more detailed description of our process can be found in our administrative rules.

What you can expect from us:

  • Always treating you with courtesy and respect.
  • Offering a reasonable opportunity for you to voice concerns.
  • Clearly explaining our process.
  • Keeping you informed of actions taken on your case.
  • Sharing why we make our decisions.
  • Protecting your private information.
  • Considering your feedback so we can improve.
  • Letting you know before we limit communication due to your unacceptable conduct.

Our expectations of you:

  • Treating us with courtesy and respect.
  • Providing accurate information.
  • Providing information to identify your case.
  • Clearly describing your concern.
  • Informing us of actions by other HHS staff or others working on your case.
  • Cooperating with staff assigned to your case.
  • Avoiding making duplicate requests.
  • Considering the options and recommendations we give you.
  • Asking questions if you don’t understand our response.

Unacceptable conduct:

We will not accept behaviors such as excessively contacting our office, making unreasonable demands, threats or insults.

When you call us:

When you call us at 877-787-8999, you will be given the option of hearing our information in English or Spanish. You will be advised that the call may be recorded and asked to verify your identity.

  • Option 1: Out-of-state eligibility workers are asked to call 2-1-1 to complete their requests.
  • Option 2: Consumers seeking information about their eligibility for programs such as Medicaid, SNAP food benefits, and the Temporary Assistance for Needy Families program.
  • Option 3: Consumers seeking information about the Autism program, Blind Children’s Services, Deaf and Hard of Hearing Services, Early Childhood Intervention, the Family Violence Program, or Independent Living services.
  • Option 4: Consumers seeking information about Medicaid managed care services.
  • Option 5: Consumers seeking information about federal Social Security benefits.
  • Option 0: Consumers seeking information about any other HHS program, including Healthy Texas Women or the Medical Transportation Program.

Managed care options:

When you call our Managed Care team at 866-566-8989, you will be given the option of hearing our information in English or Spanish. You will be advised that the call may be recorded and asked to verify your identity.

  • Option 1: Nursing facility residents and those with both Medicare and Medicaid.
  • Option 2: Select or change health plan.
    • STAR Members will be directed to call 800-964-2777.
    • STAR+PLUS or STAR Kids Members will be directed to call 877-782-6440.
  • Option 3: Change doctors.
    • Managed care members will be directed to contact their health plan.
    • Traditional Medicaid clients will be directed to call 800-335-8957.
  • Option 4: Billing Questions.
    • Managed care members will be directed to contact their health plan.
    • Traditional Medicaid clients will be directed to call 800-335-8957.
  • Option 5: Status of Medicaid application.
  • Option 0: Speak to an ombudsman.

Behavioral health/IDD options:

When you call our Behavioral Health or IDD teams at 800-252-8154, you will be given the option of hearing our information in English or Spanish. You will be advised that the call may be recorded and asked to verify your identity.

  • Option 1: Patients at state hospitals.
  • Option 2: Consumers having trouble getting behavioral health benefits through their health plan.
  • Option 3: Individuals with an intellectual or developmental disability, or their representatives.