NYT:
Due to the impending deadline for enrollment in a Medicare D(isaster) policy, more of the glitches that have occurred during the start-up phase are to be expected, as the phone wait is beginning to increase.
Callers to Humana, one of the largest Medicare carriers, often had to wait 30 minutes to reach a customer service representative last week. Federal standards say that 80 percent of calls must be answered in 30 seconds.
Test calls to several large insurers suggest that they frequently miss that goal, though the waiting times are much longer for Humana, [as the message says] “We are getting more calls than usual at the moment. We apologize for your wait.” [and continues] “Humana has the lowest prescription drug plan prices in most areas.”
Thomas T. Noland Jr., of Humana,
“The large amount of interest in our prescription drug plans, as the May 15 deadline approaches, means that the wait times are longer than we would like.”
continued
A federal contractor is calling insurers to determine federal compliance re: the call centers. The data collected so far re: the federal standards were “not met.” CMS stated that information would be disclosed to the public before May 15. Insurers, claiming the federal standards are too stict, are lobbying against the release of that information.
According to Mark McClellan,
federal officials would consider the performance of insurers in deciding whether to renew their contracts with Medicare next year. In addition, the agency could impose civil fines or take other enforcement action against insurers that were “substantially out of compliance” with federal standards.
There are also concerns as to compliance with the federal regualtions as insurers were watrned about “bait and switch” tactics, discovered during an investigation by Pete Stark. Some Medicare D(isaster) plans did not provide the public with complete and accurate information about the formularies, prior-authorizations, and requited step therapies.
The inaccuracies, discovered through federal monitoring and supervision of drug plans, could discourage enrollment of sicker beneficiaries with higher drug costs. Conversely, some beneficiaries might sign up without realizing how difficult it would be to get the drugs they need.
In addition, the premiums for Medicare D(isaster) average $25.00 per month, although the government has not withheld premiums from Social Security checks, which is an option. However, the government says some requests have been hung up in federal computer systems. In addition, some are being billed for of premiums that were supposed to have been deducted from their Social Security checks. Jerry D. Slaughter, 74, of Castle Rock, Colo., received the following letter from the AARP’s drug plan (UnitedHealth Group:
“We have not received payment for your AARP MedicareRx Plan premium.”…”If we do not receive payment by 5-31-2006, we will have to disenroll you.”
demanding payment of $109.04, equal to four times the monthly premium of $27.26. He had assumed that the premiums had been deducted from his Social Security checks, as he had requested.
Steven E. Hahn, of the AARP, blamed UnitedHealth who blamed Medicare who blamed Social Security.
Mark Hinkle, of Social Security
“We have processed every request for withholding that we received from Medicare.”
Now, Medicare officials claim
some requests had been repeatedly rejected by Social Security computers. Thomas Hutchinson, a senior Medicare official, reported “higher-than-expected rejections of withhold transactions by Social Security.”
The government has withheld three or four months of Medicare premiums from one month’s Social Security check, in other instances.
Margaret Jarvis of Blue Cross and Blue Shield of Texas, said her company
was receiving calls from customers irritated to see their Social Security checks sharply reduced.
Jacqueline B. Kosecoff, chief executive of Ovations Pharmacy Solutions, a unit of UnitedHealth,stated
the company had sent letters to about 225,000 people whose premiums were not properly paid or withheld. “We will try to resolve this with our members one by one.”
Meanwhile, the Salesman-In-Chief and Michael Leavitt have been travelling merrily around the country, attempting to get more to sign up for Medicare D(isaster) and have been denying the need for an extension of the enrollment period.
