Advocacy Groups Ask CMS To Improve Medicare Prescription Drug Benefit Appeals Process
The National Senior Citizens Law Center, the Center for Medicare Advocacy and the Medicare Rights Center on Tuesday sent a letter to CMS Administrator Mark McClellan that asked him to make the appeals process for the Medicare prescription drug benefit work "more fairly and efficiently" before the 2007 enrollment period begins, CQ HealthBeat reports. The six-week open enrollment period for the 2007 Medicare prescription drug benefit plan year begins on Nov. 15.
According to the letter, Medicare beneficiaries have experienced problems with the appeals process, and CMS should take action to address the issues. The letter states, "Without mandated minimum protections for beneficiaries, advocates and CMS caseworkers have no means of ensuring that plans meet their obligations."
The groups sent the letter in response to a Sept. 8 letter from McClellan that they said "does not correspond either to the requirements CMS had established for Part D plans or to the reality of the situation on the ground."
Jeffrey Kelman, chief medical officer for the Center for Beneficiary Choices at CMS, said that the agency addressed many of the concerns raised by the groups in a March guidance document. "It's important for us that everybody get to use the transition process and the appeals and exceptions process appropriately and that nobody has the necessary drugs withheld," Kelman said (CQ HealthBeat, 10/4).