GAO report
finds Medicare prescription drug plans fail to
accurately answer consumer questions
Washington, DC - A
new GAO report released today by Rep. Henry A. Waxman, Rep. John D.
Dingell, Rep. Charles B. Rangel, Rep. Pete Stark, and Rep. Sherrod
Brown finds that the call centers run by private Medicare drug plans
provide inaccurate and incomplete information most of the time.
According to GAO, the private plans that are responsible for running
the new Medicare drug benefit "did not consistently provide callers
with accurate and complete information."
"The poor quality
of the information is inexcusable," said Rep. Waxman, Ranking Member
of the Committee on Government Reform. "Seniors with basic questions
about the Medicare drug benefit are being left in the dark. Even if
they call the plans directly, they can't get accurate answers."
"The lack of
accurate and understandable information for our seniors has been a
chronic problem since the beginning of Medicare Part D," said Rep.
Dingell, Ranking Member of the Committee on Energy and Commerce.
"Senior citizens are being hurt by the indifference and incompetence
of the Bush Administration and its friends in the insurance
industry."
"Too often, the
Bush Administration blames the messenger for bad news about its
performance," commented Rep. Rangel, Ranking Member on the Committee
on Ways and Means. "In general, GAO has now found that customer
service representatives at both CMS and the plans provide
inaccurate, incomplete or misleading information more often than
not. That failure rate is unacceptable. Certainly, the plans are at
fault, but it also points to systemic problems with the program.
It's so complicated that even those who offer and administer the
benefit are confused."
"It's not enough to
simply answer the phone," said Rep. Stark, Ranking Member on the
Ways and Means Health Subcommittee. "CMS should guarantee that plans
provide accurate and complete information. If private plans can't
meet basic standards for quality service, they shouldn't be in the
program. Moreover, this report on the inadequacy of private call
centers confirms the need to re-open enrollment for 2006. People who
received inaccurate or incomplete information shouldn't have to
remain in the wrong plan or go without coverage for the rest of the
year."
"Republican leaders
made the decision to bypass Medicare and slap together a private
insurance market just for drug benefits, but it's seniors and
taxpayers who are paying for that decision. First it's complexity,
confusion and misinformation. Then it's red tape restrictions on
needed medicines, insurance benefits that stop mid-year, and drug
prices that keep growing and growing and growing," said Rep. Brown.
"There's a bill in Congress to give seniors the right to simply add
drug benefits directly to Medicare and grant Medicare the right to
negotiate bulk discounts on drug prices. Republican leaders should
finally put seniors and taxpayers first and help Democrats pass it."
GAO found that in
most instances, drug plan providers were unable to give accurate
information in response to simple questions about plan costs,
low-income coverage, plan formulary procedures, and plan utilization
management techniques. Specifically, GAO found:
Two-thirds of phone
calls to provider hotlines were not answered completely or
accurately. The phone centers operated by private Medicare providers
gave inaccurate or incomplete answers during 66% of calls. Two
Medicare plan providers gave inaccurate or incomplete information at
least 75% of the time.
Medicare drug plan
providers were unable to provide critical cost information for
seniors to choose among plans. Two GAO questions focused on which of
drug plans would provide seniors with the lowest out-of-pocket
costs, and what these costs would be. Medicare providers failed to
give accurate or complete answers over 70% of the time. In one case,
the plan sponsor hotline underestimated the actual costs by $6,000.
Low-income
beneficiaries often received inaccurate information. One question
asked which plans offered by the provider were available to
low-income beneficiaries with no premium. This question was answered
incorrectly or inaccurately 66% of the time. This is particularly
troubling given that this information was also incorrect in the 2006
Medicare & You handbook mailed to all Medicare beneficiaries.
Medicare plans
often provided conflicting answers, giving one answer on one call
and a different answer on a second call. For example, some plans
said that one of their plans was the least expensive on one call and
then said that a completely different plan was the least expensive
on a separate call.
This is the second
GAO report analyzing the drug plan information available to Medicare
beneficiaries. In May 2006, GAO analyzed the information provided to
seniors by the federal Center for Medicare and Medicaid Services,
concluding that this information was frequently confusing,
inaccurate, or incomplete. The new GAO findings show that the
private plans are also failing to answer seniors' questions, leaving
millions of seniors unable to get accurate answers to their
questions about the Medicare drug plans.
For GAO's report
and a fact sheet, please
click
here .