Medicaid Transformation Issues Form

Please share your Medicaid transformation issue with the NCMS and our partners by completing the following short form.

• If you are experiencing multiple concerns, please log individual issues separately.
• Do not use the log as a substitute for notifying the individual plan’s customer service representatives about the problems that you are experiencing.
• Do not include anything in your comments that would be considered private health information.
• * Please make sure that your first step is contacting the plan for resolution to your issue before you complete this form.*