Connecting Constituents to Health Information and Services: Resources for Congressional Offices

Connecting Constituents to Health Information and Services: Resources for Congressional Offices

Connecting Constituents to Health Information and Services: Resources for Congressional Offices

September 23, 2024

Congressional Research Service

https://crsreports.congress.gov

R48191

Congressional Research Service

SUMMARY

Connecting Constituents to Health Information and Services: Resources for Congressional Offices

As part of their representational activities, Members of Congress and their staffs provide a range of information and services to constituents. Some constituent communications reflect concerns about health and health care. For example, constituents may have difficulty finding and using health coverage; questions about finding health providers and facilities; hardships related to medical costs; requests for information on diseases, conditions, or treatments; or complaints about health providers, facilities, and products. To address these concerns, congressional offices may refer eligible constituents to various federal, state, and local resources and programs.

This report compiles selected resources and contacts that congressional offices can use when responding to constituents’ inquiries regarding health and health care concerns. When possible, it lists federally funded referral services that provide individual assistance to constituents and matches specific circumstances to relevant federal, state, or local programs. Constituents can use these online resources, or discuss their specific situations with trained staff at the listed hotlines, to identify and access programs, resources, and benefits relevant to their needs.

This report is organized into five sections, with resources and contacts for

• finding and using health coverage;

• finding health providers and facilities;

• financial hardship related to medical costs;

• information on diseases, conditions, and treatments; and

• complaints about health care providers, facilities, or products.

The Appendix lists selected CRS reports for congressional clients seeking (1) additional resources to support their work with constituents and (2) background on some of the programs and policy issues mentioned in this report. This report is not intended to be a comprehensive catalog of all relevant resources and contacts; rather, it emphasizes federal or federally supported resources and hotlines to address constituents’ frequently asked questions.

R48191

September 23, 2024

Sarah K. Braun Research Librarian

Kate M. Costin Research Librarian

Michele L. Malloy Senior Research Librarian

Angela Napili Senior Research Librarian

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Contents

Introduction ..................................................................................................................................... 1 Resources and Contacts on Health Coverage .................................................................................. 1

General Resources on Finding and Understanding Health Coverage ....................................... 1 Types of Health Coverage ......................................................................................................... 3

Private Health Insurance ..................................................................................................... 3 Medicaid and State Children’s Health Insurance Program (CHIP) .................................... 3 Medicare ............................................................................................................................. 4 Military Health System ....................................................................................................... 5 Veterans Health Administration .......................................................................................... 6 Federal Employees Health Benefits Program (FEHB) ....................................................... 6 Indian Health Service (IHS) ................................................................................................ 6

Resources and Contacts for Finding Health Care Providers and Facilities ..................................... 7

Finding Health Care Professionals and Facilities ..................................................................... 7

Resources and Contacts for Financial Hardship .............................................................................. 8

Finding Help with Medical Bills or Medical Debt .................................................................... 8

Finding Free or Low-Cost Health Care ..................................................................................... 9

Finding General Financial Support .......................................................................................... 11

Resources and Contacts on Diseases, Conditions, and Treatments ............................................... 12

General Health Hotlines, Directories, and Information Resources ......................................... 12 COVID-19 ............................................................................................................................... 13

HIV/AIDS ............................................................................................................................... 13 Mental Health and Substance Use Disorders (Behavioral Health) ......................................... 14 Pharmaceuticals....................................................................................................................... 14

Resources and Contacts for Complaints ........................................................................................ 15

General Resources ................................................................................................................... 15

Complaints About Drugs, Medical Devices, Dietary Supplements, and Vaccines.................. 15 Complaints About Health Care Facilities and Providers ......................................................... 16

Appendixes

Appendix. Selected CRS Reports .................................................................................................. 18

Contacts

Author Information ........................................................................................................................ 19

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Introduction

As part of their representational activities, Members of Congress and their staffs provide a range of information and services to constituents. Some constituent communications reflect concerns about health and health care, such as problems finding or using health coverage, questions about finding health providers and facilities, difficulties with paying for medical care, hardships related to health conditions, and complaints about health providers, facilities, and products. To address these concerns, congressional offices may refer eligible constituents to various federal, state, and local programs and resources.

This report compiles selected resources and contacts that congressional offices can use when responding to constituents’ inquiries regarding health and health care concerns. When possible, it lists federally funded referral services that provide individual assistance to constituents and matches specific circumstances to relevant federal, state, or local programs. Constituents can use these online resources, or discuss their specific situations with trained staff at the listed hotlines, to identify and access programs, resources, and benefits relevant to their needs.

This report is organized into five sections, with resources and contacts for

• finding and using health coverage;

• finding health providers and facilities;

• financial hardship related to medical costs;

• information on diseases, conditions, and treatments; and

• complaints about health care providers, facilities, or products.

The Appendix lists selected CRS reports for congressional clients seeking (1) additional resources to support their work with constituents and (2) background on some of the programs and policy issues mentioned in this report.

This report is not intended to be a comprehensive catalog of all relevant resources; rather, it emphasizes selected federal or federally funded resources for questions that constituents frequently ask.

Resources and Contacts on Health Coverage

The information and contacts below may help congressional offices reply to consumers with questions about finding health coverage and problems with using their specific health coverage.

General Resources on Finding and Understanding Health Coverage

Some constituents may be eligible for free or low-cost coverage through Medicaid, the State Children’s Health Insurance Program (CHIP), or private coverage through health insurance exchanges (also called marketplaces). The resources below, maintained by the Centers for Medicare & Medicaid Services (CMS), can help constituents learn about and apply for such coverage.¹

• HealthCare.gov (1-800-318-2596) https://www.healthcare.gov/

1 CRS Report R47351, Immigrants’ Access to Health Care, summarizes health coverage options and eligibility for immigrants, including authorized and unauthorized immigrants, which may differ from options for U.S. citizens.

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This website and hotline connect constituents to the relevant federal or state health insurance exchange (marketplace), where constituents can learn if they may be eligible for Medicaid, CHIP, or the exchange’s private health plans (as well as premium and cost-sharing subsidies). Constituents can also compare health plans and apply for coverage. Assistance is available in multiple languages.

• HealthCare.gov: Find Local Help https://localhelp.healthcare.gov/ This online directory identifies state and local organizations and “assisters” trained to help constituents understand their health coverage options (including private coverage, Medicaid, and CHIP), determine eligibility for premium and cost-sharing subsidies, and provide enrollment assistance. The directory also includes insurance agents and brokers.

In general, health plan enrollees may contact their plans directly to verify enrollment or to ask about coverage of specific drugs, medical services, and health care providers. Enrollees can find their health plan’s customer service phone number on their insurance card or on the health plan’s website. Below are additional resources maintained by CMS that provide contacts for health coverage questions and problems.

• Consumer Assistance Program https://www.cms.gov/cciio/resources/consumer-assistance-grants This website provides an interactive map of state-level contacts for assistance with health insurance questions. Some states operate Consumer Assistance Programs (CAPs), where staff can assist with health insurance problems and questions. For states with no CAP, the map links to other contacts for resolving health insurance problems, such as the state insurance department or Medicaid agency.

• Coverage to Care https://www.cms.gov/priorities/health-equity/c2c This website provides consumer booklets and videos on using health coverage to get care. Topics include “Navigate Your Coverage,” “Access Care,” and “Manage Your Chronic Condition,” among others. Some resources have been translated to other languages.

• Find a patient advocate https://www.cms.gov/medical-bill-rights/help/guides/patient-advocate This website has tips and resources for finding a patient advocate. For constituents with chronic or serious health conditions, patient advocates can help navigate the health care system, for example by helping patients communicate with insurers and providers to obtain needed care.²

2 According to the National Cancer Institute, a patient advocate is a “person who helps guide a patient through the healthcare system. This includes help going through the screening, diagnosis, treatment, and follow-up of a medical condition, such as cancer. A patient advocate helps patients communicate with their healthcare providers so they get the information they need to make decisions about their health care. Patient advocates may also help patients set up appointments for doctor visits and medical tests and get financial, legal, and social support. They may also work with insurance companies, employers, case managers, lawyers, and others who may have an effect on a patient’s healthcare needs. Also called patient navigator.” National Cancer Institute, Dictionary of Cancer Terms, https://www.cancer.gov/ publications/dictionaries/cancer-terms/def/patient-advocate.

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Types of Health Coverage

Private Health Insurance

Private Health Insurance (PHI) is the most common form of health coverage in the United States. PHI plans are subject to federal and state requirements. PHI plan enrollees generally obtain their coverage through either, or occasionally both, of the following sources: an employment setting (group plans) or directly from an insurer (nongroup plans). The nongroup market (also called the individual market) and the small-group market include plans sold on and off the health insurance exchanges. The Appendix includes CRS reports that provide background information on this topic.

• Employee Benefits Security Administration: Ask EBSA (1-866-444-3272) https://www.dol.gov/agencies/ebsa/about-ebsa/ask-a-question/ask-ebsa This website connects constituents with benefit advisors at the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA). Benefit advisors can respond to questions about an enrollee’s job-based health coverage. Constituents can also submit their questions or complaints through an online form available on this website. EBSA can assist with “self-insured” plans, which are typically health insurance plans received through large employers or employers with locations in more than one state or country.

• Know What Treatments Your Health Insurance Covers https://www.samhsa.gov/find-support/how-to-pay-for-treatment/know-what- your-insurance-covers This website from the Substance Abuse and Mental Health Services Administration (SAMHSA) provides guidance on how to identify an enrollee’s mental health and substance abuse treatment coverage under their existing health plan. Most private health insurance plans cover mental health and substance abuse treatment. However, not all plans cover such treatment, and some will cover only certain levels of care.

Medicaid and State Children’s Health Insurance Program (CHIP)

Medicaid and CHIP are means-tested health coverage programs for certain low-income populations. Each state designs and administers its own Medicaid and CHIP programs within federal guidelines. Eligibility criteria and benefits vary by state. Medicaid finances primary and acute medical services, as well as long-term services and supports. CHIP provides health coverage to certain children and pregnant people with family incomes too high to qualify for Medicaid. The following resources, provided by the Centers for Medicare & Medicaid Services (CMS), help constituents identify offices and information on CHIP and Medicaid. The Appendix includes CRS reports that provide background on these programs.

• Where Can People Get Help With Medicaid & CHIP? https://www.medicaid.gov/about-us/where-can-people-get-help-medicaid-chip/ index.html This website lists state program websites and contacts for determining Medicaid and CHIP eligibility, applying for Medicaid or CHIP, and getting assistance with

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other related questions and problems. If a state agency cannot help, the CMS headquarters number for Medicaid questions is 877-267-2323.³

• Renew Your Medicaid or CHIP Coverage⁴ https://www.medicaid.gov/resources-for-states/coronavirus-disease-2019-covid- 19/unwinding-and-returning-regular-operations-after-covid-19/renew-your- medicaid-or-chip-coverage/index.html This website lists state-level websites and contacts to help constituents renew their Medicaid and CHIP coverage or find alternative coverage if they are no longer eligible.

• CMS Regional Offices https://www.cms.gov/about-cms/where-we-are/regional-offices This website lists email addresses for CMS regional offices that can help answer beneficiaries’ questions and concerns. Among its other duties, CMS is the federal agency that provides federal administrative guidance and oversight for Medicaid and CHIP. However, the state Medicaid agency is often a better first point of contact; see CMS’s “You Must Contact Your State Medicaid Agency to ... ” at https://www.medicaid.gov/about-us/where-can-people-get-help-medicaid-chip/ index.html.

• InsureKidsNow.gov (1-877-KIDS-NOW or 1-877-543-7669) https://www.insurekidsnow.gov/coverage/index.html This website and hotline can assist constituents with questions about Medicaid and CHIP health and dental coverage for children. Click the website map for each state’s CHIP and Medicaid contact information.

Medicare

Medicare is a federal program that pays for covered health care services of qualified beneficiaries. It was established in 1965 under Title XVIII of the Social Security Act to provide health insurance to individuals aged 65 and older, and it has been expanded over the years to include permanently disabled individuals under the age of 65. Medicare, which consists of four parts (A-D), covers hospitalizations, physician services, prescription drugs, skilled nursing facility care, home health visits, and hospice care, among other services. Generally, individuals are eligible for Medicare if they or their spouse worked for at least 40 quarters in Medicare- covered employment, are aged 65 or older, and are a citizen or permanent resident of the United States. Individuals may also qualify for coverage if they are a younger person who cannot work because they have a medical condition that is expected to last at least one year or result in death, or have end-stage renal disease (permanent kidney failure requiring dialysis or transplant). The Appendix includes CRS reports that provide additional background on this program.

3 Centers for Medicare & Medicaid Services, Contact Us, https://www.medicaid.gov/about-us/contact-us/index.html.

4 Under the Families First Coronavirus Response Act, as a condition of receiving a temporary increase in the federal Medicaid matching rate, states were required to maintain enrollment of most Medicaid enrollees during much of the COVID-19 pandemic. Starting April 2023, states could begin to return to normal eligibility and enrollment operations, and could terminate Medicaid coverage of those no longer eligible. According to CMS, “The expiration of the continuous enrollment condition authorized by the Families First Coronavirus Response Act (FFCRA) presents the single largest health coverage transition event since the first open enrollment period of the Affordable Care Act.” For background, see CMS, Unwinding and Returning to Regular Operations after COVID-19, https://www.medicaid.gov/ resources-for-states/coronavirus-disease-2019-covid-19/unwinding-and-returning-regular-operations-after-covid-19/ index.html.

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• Medicare.gov https://www.medicare.gov/ This website provides extensive information about Medicare basics, coverage, providers and services, claims and appeals, and help options.

• Medicare & You https://www.medicare.gov/medicare-and-you This handbook is a beneficiary’s guide to Medicare. Available in print and electronic formats, this resource is updated each fall and has information about Medicare benefits, costs, rights, and protections. Beneficiaries are mailed print copies, and downloads are available in a variety of formats and languages.

• State Health Insurance Assistance Program (SHIP) https://www.shiphelp.org/ This resource focuses on SHIPs, which provide local, in-depth, and objective insurance counseling and assistance to Medicare-eligible individuals, their families, and caregivers. Click the “SHIP Locator” to select the applicable state and view contact information and state-level websites.

• Medicare.gov: Talk to Someone https://www.medicare.gov/talk-to-someone This interactive resource facilitates opportunities for individuals to talk or live chat with a professional about Medicare issues. It provides answers to questions about Medicare and includes contacts for topics such as enrollment, complaints and appeals, and Medicare costs and options. Call 1-800-MEDICARE (1-800- 633-4227).

• Medicare.gov: Get help with costs https://www.medicare.gov/basics/costs/help These sources help Medicare beneficiaries discover savings programs for premiums, manage prescription drug costs, and lower health plan costs.

Military Health System

The Military Health System (MHS) provides health care to military personnel, retirees, and their families in Department of Defense (DOD) hospitals and clinics—known as military treatment facilities—and through civilian health care providers participating in TRICARE, a DOD- administered health insurance-like program. The Appendix includes CRS reports that provide additional background information on this topic.

• About the MHS: Contact Us https://health.mil/About-MHS/Contact-Us This website has contact forms, hotlines, and frequently asked questions on topics such as reporting fraud, getting reproductive or contraceptive care, and accessing medical records.

• TRICARE: Patient Resources: Contact Us https://tricare.mil/PatientResources/ContactUs This website has a “Call Us” tool to identify appropriate contacts, such as phone numbers for nurse advice, dental questions, eligibility questions, and more. The site also has provider directories, forms for asking benefit questions, instructions for filing complaints, and answers to frequently asked questions.

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Veterans Health Administration

The Department of Veterans Affairs (VA) provides health care and health-related services through the Veterans Health Administration (VHA). VHA’s primary mission is to provide health care services to eligible veterans. It also provides health care to some family members through the Civilian Health Medical Program of the Department of Veterans Affairs (CHAMPVA). See the Appendix for additional CRS products that provide background information about this agency.

• VA: Contact Us https://www.va.gov/contact-us/ This portal provides online and phone contact information for a variety of VA services, including health contacts. This site also includes a chatbot, or the “Ask VA” online tool. The VA health benefits hotline is 877-222-8387, and the My HealtheVet help desk is 877-327-0022. The Veterans Crisis Line can be reached by dialing 988.

• Find VA Locations: Health Services https://www.va.gov/find-locations/?facilityType=health This website allows users to search by location for VA health facilities and includes the ability to narrow by service type (e.g., mental health, women’s health).

• Veterans Health Administration https://www.va.gov/health/ This website is intended for multiple user groups, including veterans, providers, and policy staff, and it provides resources for specific health conditions and treatments, as well as groups such as homeless veterans, seniors and aging veterans, rural veterans, women veterans. The website also links to research and annual reports.

• VA Health Care https://www.va.gov/health-care/ This website is intended primarily for veterans, and it provides links to health care resources, locations, and extensive benefit information.

Federal Employees Health Benefits Program (FEHB)

FEHB provides health insurance to many federal employees, retirees, and their dependents. Current Members of Congress and certain congressional staff are not eligible to enroll in plans offered under FEHB as employees but may be eligible to enroll in retirement. For additional background information, see the Appendix.

• Contact Healthcare & Insurance https://www.opm.gov/healthcare-insurance/contact-healthcare-insurance/ This U.S. Office of Personnel Management website lists contacts for FEHB questions, complaints, and disputes. In many cases, FEHB enrollees can pose their initial questions to their employing agency Human Resources Office or their health plan.

Indian Health Service (IHS)

IHS, an agency within the U.S. Department of Health and Human Services (HHS), is responsible for providing federal health services to American Indians and Alaska Natives. For additional information on this topic, see the Appendix.

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• IHS: Contact Information https://www.ihs.gov/contact/ This website provides specific forms regarding website issues or claims status. Public Affairs Office contact information is also provided.

• IHS: Find Health Care https://www.ihs.gov/forpatients/findhealthcare/ This website provides search box and map options to locate Indian Health Service, Tribal, or Urban Indian Health Program facilities. Users can narrow to specific facility types, including dental clinics and behavioral health facilities.

• IHS: For Patients https://www.ihs.gov/forpatients/ This portal allows patients to gather a variety of health information, including health topics, personal health records, and patient forms.

• IHS: Frequently Asked Questions https://www.ihs.gov/forpatients/faq/ This compilation of basic questions applicable to individuals seeking health care and benefits through the agency includes information regarding eligibility, access, and complaints.

Resources and Contacts for Finding Health Care Providers and Facilities

Constituents may seek help finding local health care facilities or providers. In addition to the sources below, which provide initial assistance, a number of states offer tools that may help congressional offices respond to such requests. Constituents may also contact their health insurance (e.g., private health insurance, Medicare, Medicaid) to identify providers and determine if providers are in-network or accept their insurance.

Finding Health Care Professionals and Facilities

• MedlinePlus: Directories https://medlineplus.gov/directories/ This National Library of Medicine (NLM) website provides links to directories to help constituents find libraries, health professionals, services, and facilities. NLM does not endorse or recommend the organizations that produce these directories, nor the individuals or organizations that are included in the directories.

• Healthcare.gov: Getting regular medical care https://www.healthcare.gov/using-marketplace-coverage/getting-medical-care/ This website provides tips on locating providers who participate in an individual’s health plan.

• Medicare.gov: Care Compare https://www.medicare.gov/care-compare/ This tool can be used to find and compare different types of Medicare providers, including physicians, hospitals, and nursing homes.

• U.S. Department of Health and Human Services: Health Care Providers & Facilities https://www.hhs.gov/programs/social-services/health-care-facilities/index.html

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This listing of governmental sources allows users to locate health care providers and facilities and compare options. The list includes free or low-cost care (Health Resources & Services Administration), Alzheimer’s Disease Research Centers (National Institutes of Health, or NIH), Cancer Centers (NIH), and Mammography Certified Facilities (FDA).

• Health Care Practitioners databases in State Agency Databases https://godort.libguides.com/healthpractionerdbs This compilation of state databases is maintained by the American Library Association’s Government Documents Round Table and includes links to state- specific sources of information regarding various health professionals. See the bottom of the page for the “last updated” date.

Resources and Contacts for Financial Hardship

The contacts and information below may help congressional offices respond to constituents facing financial hardship due to medical costs. These resources can also help constituents find information on free or low-cost health care and general financial support. For information on assisting uninsured constituents, see the “General Resources on Finding and Understanding Health Coverage” section.

Finding Help with Medical Bills or Medical Debt

The following resources may help constituents facing hardship with medical bills or medical debt.

• Centers for Medicare & Medicaid Services: No Surprises Help Desk (1-800-985- 3059) https://www.cms.gov/medical-bill-rights/help The Centers for Medicare & Medicaid Services (CMS) No Surprises Help Desk and website can provide “answers about your medical billing situation.” The No Surprises Act protects consumers from certain unexpected out-of-network medical bills.⁵ Help Desk staff can help constituents determine whether the No Surprises Act applies to their situation. If constituents believe that their provider or insurer is not following relevant billing rules, they can submit a complaint. The Help Desk can also direct constituents to other resources and agencies if their billing situation is not covered by the No Surprises Act. Phone assistance is available in multiple languages. Constituents can also use online forms to ask questions, submit complaints, and dispute bills.

• Consumer Financial Protection Bureau: Is there financial help for my medical bills? https://www.consumerfinance.gov/ask-cfpb/is-there-financial-help-for-my- medical-bills-en-2124/ This Consumer Financial Protection Bureau website has tips for how to ask about and apply for hospital financial assistance programs. Some states have charity care laws that require certain hospitals to provide free or discounted care to eligible patients. Federal law also generally requires nonprofit hospitals to have a

5 CRS Report R46856, Surprise Billing in Private Health Insurance: Overview of Federal Consumer Protections and Payment for Out-of-Network Services, summarizes consumer protections in the No Surprises Act (P.L. 116-260, Division BB, Title I).

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written Financial Assistance Policy and a written Emergency Medical Care policy.⁶

• Federal Trade Commission: Consumer Advice: Debt Collection FAQs https://consumer.ftc.gov/articles/debt-collection-faqs This Federal Trade Commission website provides answers to questions that constituents may have about debt collection, including medical debt collection. In particular, this resource provides information about consumer rights under the Fair Debt Collection Practices Act.

• Medline Plus: Financial Assistance https://medlineplus.gov/financialassistance.html This National Library of Medicine website provides curated resources and tips for paying for health care. For example, it notes that “you can also discuss concerns about paying your medical bills with your health care provider, social worker or the business office of your clinic or hospital” and links to patient handouts such as “Eight ways to cut your health care costs.”

• National Institutes of Health: Genetic and Rare Diseases Information Center (1- 888-205-2311) https://rarediseases.info.nih.gov/contact This National Institutes of Health (NIH) information center has compiled resources on affording medical care (scroll to “Resources” and click on “How can you afford the medical care you need?”). Many of the listed organizations assist with a wide range of serious medical conditions, not just genetic and rare diseases. Constituents can also call or email the center, where staff can refer them to additional resources for their specific needs.

Finding Free or Low-Cost Health Care

The resources below can help constituents find free or affordable health services in their communities.

• Health Resources & Services Administration: Get Affordable Health Care https://www.hrsa.gov/get-health-care/affordable This Health Resources & Services Administration (HRSA) website has directories for (1) health centers, which have sliding fee scales and serve people regardless of insurance status or ability to pay; (2) Hill-Burton facilities, which are required to provide a certain amount of free or below-cost health care to people who meet income guidelines; and (3) Ryan White Programs, which provide health care and support services to eligible people living with HIV/AIDS.

The resources below provide information on free or low-cost specialized health services related to maternal and child health, family planning, dental health, behavioral health, eye health, HIV/AIDs, and sexually transmitted infections. (Some of the contacts and websites in the “Resources and Contacts on Diseases, Conditions, and Treatments” section also provide information on free or low-cost specialized health services.)

6 Internal Revenue Service, Financial Assistance Policy and Emergency Medical Care Policy – Section 501(r)(4), https://www.irs.gov/charities-non-profits/financial-assistance-policy-and-emergency-medical-care-policy-section- 501r4.

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• Are there any health assistance programs for pregnant women, mothers, and children? (1-800-311-BABY) https://www.hhs.gov/answers/health-insurance-reform/are-there-health- assistance-programs-for-pregnant-women-mothers-children/index.html This U.S. Department of Health and Human Services (HHS) website lists contacts for free or reduced cost prenatal care: 1-800-311-BABY (1-800-311- 2229); for Spanish, call 1-800-504-7081. These numbers can connect callers to their area’s health department.

• Maternal and Child Health Bureau: State Hotlines: National https://mchb.tvisdata.hrsa.gov/Home/StateHotlines This HHS Maternal and Child Health Bureau website lists state hotlines for information and assistance with health services for pregnant persons, maternal health, infants, and children.

• Find a Family Planning Clinic https://opa-fpclinicdb.hhs.gov/ From the HHS Office of Population Affairs, this directory lists clinics participating in the federal Title X Family Planning Program. Title X clinics offer family planning counseling and supplies (including contraception and natural family planning methods) and related preventive health services (including cervical cancer screenings). Clients may qualify for free or discounted care.

• Finding Dental Care https://www.nidcr.nih.gov/health-info/finding-dental-care This National Institute of Dental and Craniofacial Research website includes “Where can I find low-cost dental care?” and “Related publications” which links to Finding Low-Cost Dental Care: Information for Caregivers. It has contact information for dental schools, dental hygiene schools, and clinical trials, among other sources of free or low-cost oral health care.

• FindTreatment.gov (800-662-HELP or 800-662-4357) https://findtreatment.gov/ This Substance Abuse and Mental Health Services Administration (SAMHSA) directory can help constituents find mental health and substance use disorder treatment facilities in their communities. The directory includes facilities with sliding fee scales and payment assistance. After obtaining search results, click “Show More” at the bottom of the “Filter by” menu on the left navigation bar, then filter by “Payment assistance available.” The hotline can also refer callers to local facilities, support groups, and community-based organizations. For additional tips, see Find Free or Low-Cost Treatment or Support for Mental Health, Drugs, or Alcohol, https://www.samhsa.gov/find-support/how-to-pay-for- treatment/free-or-low-cost-treatment.

• Get Free or Low-Cost Eye Care https://www.nei.nih.gov/learn-about-eye-health/healthy-vision/get-free-or-low- cost-eye-care This National Eye Institute (NEI) website lists resources and organizations that offer free or low-cost eye exams, eyeglasses, cataract surgery, glaucoma surgery, white canes, and blindness prevention services.

• Get Tested: National HIV, STD, and Hepatitis Testing https://gettested.cdc.gov/ This Centers for Disease Control and Prevention (CDC) website has a directory

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of free and confidential HIV, sexually-transmitted infection (STI), and hepatitis testing locations.

• HIV.gov: Find HIV Services Near You https://locator.hiv.gov/ This searchable HHS map and directory includes local providers of services such as testing, mail-in self-tests, Pre-Exposure Prophylaxis (PrEP), condoms, Mpox vaccine, HIV care and treatment, health centers, behavioral health services, family planning, and housing assistance.

• Find a Ryan White HIV/AIDS Program Medical Provider https://findhivcare.hrsa.gov/ This HRSA searchable map and directory can help constituents find local Ryan White providers. Ryan White Programs provide a range of health care services, medications, and support services to eligible people living with HIV/AIDS.

Finding General Financial Support

The resources below can help constituents identify other benefits and services for which they may be eligible. Although some of these programs might not pay for health care directly, they might provide financial relief in other ways.

• USA.gov: Government benefits https://www.usa.gov/benefits This online tool, the product of a federal interagency collaboration, provides access to information on federal and state program benefits for individuals. Programs can be browsed by category (e.g., “Food assistance,” “Help with utility bills”). USA.gov also has a phone hotline (1-844-USA-GOV1) and online chat https://www.usa.gov/chat.

• 211: Find Help Near You https://www.211.org/about-us/your-local-211 This website and phone number can help constituents identify assistance and resources in their local communities. The Federal Communications Commission has designated 211 as the three-digit phone number for information and referrals to social services, rental assistance, food banks, job training, financial assistance, and other local assistance.

• Help for Families https://www.acf.hhs.gov/ofa/map/about/help-families This website includes a directory of state “General Benefits” centralized benefit portals. Constituents can use these portals to find and apply for multiple benefit programs. The directory also lists state general information hotlines and state contacts for the Temporary Assistance for Needy Families (TANF) program. States use TANF block grants to fund cash assistance and a wide range of services and benefits for low-income families with children. This website is maintained by the U.S. Department of Health and Human Services, Office of Family Assistance.

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Resources and Contacts on Diseases, Conditions, and Treatments

The resources and contacts below may help constituents with questions or problems related to health conditions or diseases. These resources are not a substitute for seeing a health care provider. General health hotlines, directories, and information resources are listed first, followed by resources on COVID-19, HIV/AIDS, behavioral health (including mental health and substance use disorders), and pharmaceuticals. Constituents may want to consult state-specific information sources, such as the state health department, for additional information.

General Health Hotlines, Directories, and Information Resources

• CDC-INFO (800-CDC-INFO or 800-232-4636) https://www.cdc.gov/cdc-info/ This source, through the Centers for Disease Control and Prevention (CDC), provides live phone and email assistance for constituents’ public health and safety questions on hundreds of topics. Staff can help callers “find the latest and reliable science-based health information.”

• Federal Health Information Centers and Clearinghouses https://health.gov/our-work/national-health-initiatives/health-literacy/resources/ national-health-information-center/topic This directory, maintained by the U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion, describes federal hotlines and online resource centers where constituents can receive information and referrals on a wide range of health-related topics and services.

• Health Info Lines https://www.nih.gov/health-information/health-info-lines This directory lists National Institutes of Health (NIH) phone numbers that the public can call to ask about topics such as stroke, diabetes, cancer, Alzheimer’s Disease, women’s health, and more.

• MedlinePlus https://medlineplus.gov/ This website, from the National Library of Medicine (NLM), connects constituents to plain language information on health and medical topics, including drugs and supplements, disorders and conditions, and diagnosis and therapy. Many of the topic pages have a “Find an Expert” section that directs constituents to information and services for their specific needs. Materials are available in English and Spanish.

• MedlinePlus: Directories https://medlineplus.gov/directories/ This NLM directory list can help constituents find libraries, health professionals, services, and facilities. NLM does not endorse or recommend the organizations that produce these directories, nor the individuals or organizations included in the directories. MedlinePlus: Organizations https://medlineplus.gov/organizations/all_organizations.html This list, from NLM, includes governmental and selected nongovernmental

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organizations, such as patient support and advocacy groups, that provide consumer health content on a range of diseases and conditions. Many of these organizations can help constituents find services and support groups for their conditions.

COVID-19

• COVID.gov (1-800-232-0233) https://www.covid.gov/ This U.S. Department of Health and Human Services (HHS) website and Centers for Disease Control and Prevention (CDC) hotline provide county-specific COVID-19 guidance and information on COVID-19 testing, treatment, masks, and vaccines.

• Services and Supports for Longer-Term Impacts of COVID-19 https://www.covid.gov/assets/files/Services-and-Supports-for-Longer-Term- Impacts-of-COVID-19-08012022.pdf This HHS report, released in August 2022, describes federal programs, hotlines, and websites, including federal supports and services for Americans experiencing long COVID and services for individuals dealing with mental health, substance use, or bereavement challenges in the wake of the pandemic. Additional long COVID consumer resources are available at https://www.covid.gov/be-informed/ longcovid.

• Vaccines.gov https://www.vaccines.gov/ This CDC vaccine finder enables users to search for COVID-19 and other vaccines nearby. The website notes that users should check with the selected vaccination site or their insurer to confirm that the site is in network.

• COVID-19, Flu and RSV https://www.fda.gov/consumers/covid-19-flu-and-rsv This Food and Drug Administration (FDA) consumer guide provides information on FDA-authorized and approved vaccines, tests, and treatments for all three illnesses.

HIV/AIDS

• State HIV/AIDS Hotlines https://ryanwhite.hrsa.gov/hiv-care/hotlines This Health Resources & Services Administration (HRSA) website lists state HIV/AIDS hotlines for finding information and services. Under “Find Help,” this page lists national HIV/AIDS resources, including the Centers for Disease Control and Prevention’s (CDC’s) HIV service locator (800-232-4636) and an HIV information hotline from the National Institutes of Health (NIH) (800-448- 0440).

• HIV.gov: Find HIV Services Near You https://locator.hiv.gov/ This searchable U.S. Department of Health and Human Services (HHS) map and directory includes local providers of services such as testing, mail-in self-tests, Pre-Exposure Prophylaxis (PrEP), condoms, Mpox vaccine, HIV care and

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treatment, health centers, behavioral health services, family planning, and housing assistance.

Mental Health and Substance Use Disorders (Behavioral Health)

• 988 Suicide & Crisis Lifeline https://988lifeline.org/ Constituents can use the Lifeline to call, text, or chat with trained counselors. Persons in distress can dial 988 for free and confidential support 24 hours a day, seven days a week. Assistance is available in multiple languages. The Lifeline is supported by the Substance Abuse and Mental Health Services Administration (SAMHSA).

• FindSupport.gov (800-662-4357) http://findsupport.gov This SAMHSA national helpline and website provides information and referrals to local services, support groups, and organizations for mental health, alcohol, and substance use disorders.

• National Maternal Mental Health Hotline (1-833-TLC-MAMA) https://mchb.hrsa.gov/programs-impact/national-maternal-mental-health-hotline This 24/7 phone and text hotline provides free and confidential mental health support for pregnant and new mothers, as well as referrals to local and telehealth providers and support groups. Assistance is available in multiple languages. The hotline is administered by the Health Resources & Services Administration (HRSA).

• Disaster Distress Helpline (1-800-985-5990) https://www.samhsa.gov/find-help/disaster-distress-helpline Constituents experiencing emotional distress related to natural or human-caused disasters can call or text this SAMHSA helpline. It provides 24/7 year-round multilingual crisis counseling, coping tips, and referrals for follow-up support. The helpline is open to anyone affected by disasters, including survivors, victims’ loved ones, parents, caregivers, first responders, clergy, and rescue, recovery, and relief workers. Disasters may include mass violence incidents, community unrest incidents, anniversaries and trigger events, infectious disease outbreaks, and natural disasters, such as earthquakes, storms, and wildfires, among other disasters.

Pharmaceuticals

• FDA Drug Shortages https://www.accessdata.fda.gov/scripts/drugshortages/default.cfm This Food and Drug Administration (FDA) database provides up-to-date drug shortage information, including manufacturer contact information, current product availability, and estimated shortage duration. This database can be searched by product name or active ingredient.

• Drug Recalls https://www.fda.gov/drugs/drug-safety-and-availability/drug-recalls This FDA website provides an interactive, searchable table with drug recall information. A drug recall is a voluntary action by a drug manufacturer to remove a defective drug product from the market or warn patients and consumers about a

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potential risk. A recall is conducted on a company’s own initiative or by FDA request. The information in this table is acquired by the FDA through public notification of a recall issued by the drug manufacturer.

• FDA Pharmacists Help You Use Medicines Safely https://www.fda.gov/consumers/consumer-updates/fda-pharmacists-help-you- use-medicines-safely This consumer site from FDA’s Division of Drug Information (DDI) provides the contact information for FDA’s staff of pharmacists who respond to questions about human drugs for the U.S. public. DDI staff respond to inquiries such as how to identify a tablet or pill, possible drug side effects, and how to discard unused medication.

• National Prescription Drug Take Back Day https://www.deadiversion.usdoj.gov/drug_disposal/takeback/takeback.html This U.S. Department of Justice’s Drug Enforcement Administration event aims to provide a safe, convenient, and responsible means of disposing of prescription drugs, while also educating the general public about the potential for abuse of medications. This website allows users to search for a nearby collection site and information on year-round pharmaceutical disposal locations.

Resources and Contacts for Complaints

When constituents contact congressional offices with complaints about health care providers, facilities, or products, the resources and contacts below may help such constituents file their complaints with the appropriate agency. For complaints about providers, facilities, and products not listed below, congressional offices can contact CRS.

General Resources

• Complaints & Appeals https://www.hhs.gov/regulations/complaints-and-appeals/index.html This U.S. Department of Health and Human Services (HHS) website compiles links for filing complaints about health care civil rights and discrimination, health information privacy, poor hospital care, health insurance company decisions, and health care fraud, abuse, and waste, among other types of health care complaints.

• How to Complain and Get Heard https://www.ahrq.gov/patients-consumers/patient-involvement/how-to- complain.html This Agency for Healthcare Research and Quality website has tips and contacts for constituents to communicate and complain effectively about unsafe or low- quality care. The website also links to state medical boards that can help constituents file complaints in their state.

Complaints About Drugs, Medical Devices, Dietary Supplements, and Vaccines

• Contact FDA (1-888-INFO-FDA, or FDA’s emergency line 1-866-300-4374) https://www.fda.gov/about-fda/contact-fda This Food and Drug Administration (FDA) website explains how constituents can report problems with FDA-regulated products, including drugs, medical

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devices, and dietary supplements. It includes a directory of state FDA Consumer Complaint Coordinators, at https://www.fda.gov/safety/report-problem-fda/ consumer-complaint-coordinators.

• MedWatch Online Voluntary Reporting Form https://www.accessdata.fda.gov/scripts/medwatch/index.cfm This FDA form allows health professionals, consumers, and patients to voluntarily report observed or suspected adverse events for human medical products to the agency. Consumers can submit a MedWatch Voluntary Report to the FDA to report an issue with a drug, medical device, or other medical product.

• Vaccine Adverse Event Reporting System (VAERS) (1-800-822-7967) https://vaers.hhs.gov/ This online form allows constituents to report a reaction or adverse event following a vaccination. Reports may be submitted by patients, parents, caregivers, health care providers, and vaccine manufacturers. VAERS is cosponsored by the Centers for Disease Control and Prevention (CDC) and the FDA.

Complaints About Health Care Facilities and Providers

In general, states are the primary regulators of health facilities and providers, so constituents may want to contact their specific state’s department of health for additional options.

For complaints about facilities:

• Centers for Medicare & Medicaid Services (CMS): Quality, Safety & Oversight – General Information: Contact Information https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight- general-information/contact-information This CMS directory lists state agency phone numbers and websites for complaints about the quality of care in state- or federally certified health care facilities, such as hospitals. Details about regulated facility types and complaint procedures vary by state.

• Report a Patient Safety Concern or File a Complaint https://www.jointcommission.org/resources/patient-safety-topics/report-a-patient- safety-concern-or-complaint/ This site from the Office of Quality and Patient Safety within The Joint Commission, a national accrediting organization of health care facilities, accepts patient safety complaints. Submissions should not include medical records, billing invoices, or other related personal information.

For complaints about doctors:

• Contact a State Medical Board https://www.fsmb.org/contact-a-state-medical-board/ This Federation of State Medical Boards (FSMB) website lists “File a Complaint” links in each state in order to file complaints about physicians. FSMB also has tips on why, when, and how to report a doctor for unprofessional conduct or inadequate care, at https://www.docinfo.org/report-a-doctor/

For complaints about nurses:

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• National Council of State Boards of Nursing (NCSBN): Contact a U.S. Member (312-525-3600) https://www.ncsbn.org/contactbon This map links to contact information for state boards of nursing to submit complaints about nurses whose behavior is unsafe, negligent, incompetent, or unethical. Many state boards have complaint forms on their website; otherwise, constituents can call NCSBN or their state for guidance on how to submit a complaint. NCSBN also has a consumer guide to the complaint process, at https://www.ncsbn.org/public-files/A_Health_Care_Consumers_Guide.pdf.

For Medicare-related complaints:

Medicare.gov: How to file a complaint (grievance) https://www.medicare.gov/claims-appeals/how-to-file-a-complaint-grievance This site allows Medicare beneficiaries who have concerns about their quality of care to submit complaints about providers, facilities, health plans, etc.

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Appendix. Selected CRS Reports

The following CRS publications provide additional background on and analysis of some of the programs and policy issues discussed in this report.

Constituent Services

To assist older constituents or constituents with disabilities, or their caregivers, congressional offices may also consult

• CRS In Focus IF11694, Connecting Older Adults and Individuals with Disabilities to Health Services: Resources for Congressional Offices.

To assist constituents seeking grants or funding for health facilities, congressional offices may consult

• CRS Report R48081, Sources of Federal Funding for Health Care Facilities: Frequently Asked Questions, and

• CRS In Focus IF12449, Connecting Constituents with Federal Assistance for Businesses.

For congressional offices that want to work directly with federal agencies as facilitators or advocates for individual constituents, see

• CRS Report 98-446, Congressional Liaison Offices of Selected Federal Agencies;

• CRS Report RL33209, Casework in a Congressional Office; and

• CRS Report R44696, Casework in Congressional Offices: Frequently Asked Questions.

Health Policy Issues

The following report serves as a starting point for congressional staff assigned to cover issues related to health care policy. It outlines major government stakeholders, as well as relevant laws, regulations, federal programs, sources of data, and CRS products:

• CRS Report R43889, Health Policy: Resources for Congressional Offices.

The following CRS reports focus on specific health policy issues applicable to the areas covered in this report:

• CRS In Focus IF12169, An Overview of Medical Debt: Collection, Credit Reporting, and Related Policy Issues.

• CRS Report R46856, Surprise Billing in Private Health Insurance: Overview of Federal Consumer Protections and Payment for Out-of-Network Services.

• CRS Report R44832, Frequently Asked Questions About Prescription Drug Pricing and Policy.

• CRS Report R47507, Private Health Insurance: A Primer.

• CRS Report R43357, Medicaid: An Overview.

• CRS Report R40425, Medicare Primer.

• CRS Report R46426, Substance Abuse and Mental Health Services Administration (SAMHSA): Overview of the Agency and Major Programs.

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• CRS In Focus IF10530, Defense Primer: Military Health System.

• CRS Report R43922, Federal Employees Health Benefits (FEHB) Program: An Overview.

• CRS Report R43330, The Indian Health Service (IHS): An Overview.

• CRS In Focus IF10051, Title X Family Planning Program.

• CRS Report R47351, Immigrants’ Access to Health Care.

Author Information

Sarah K. Braun Research Librarian

Michele L. Malloy

Senior Research Librarian

Kate M. Costin Research Librarian

Angela Napili

Senior Research Librarian

Disclaimer

This document was prepared by the Congressional Research Service (CRS). CRS serves as nonpartisan shared staff to congressional committees and Members of Congress. It operates solely at the behest of and under the direction of Congress. Information in a CRS Report should not be relied upon for purposes other than public understanding of information that has been provided by CRS to Members of Congress in connection with CRS’s institutional role. CRS Reports, as a work of the United States Government, are not subject to copyright protection in the United States. Any CRS Report may be reproduced and distributed in its entirety without permission from CRS. However, as a CRS Report may include copyrighted images or material from a third party, you may need to obtain the permission of the copyright holder if you wish to copy or otherwise use copyrighted material.