CMS Sends Instructions for Erroneous Reimbursements
CMS last week will sent letters to the more than 230,000 Medicare beneficiaries who the agency erroneously reimbursed for their Medicare prescription drug benefit premiums to inform them of their options for repayment to the federal government, the AP/San Francisco Chronicle reports (Freking, AP/San Francisco Chronicle, 8/28).
CMS Administrator Mark McClellan on Aug. 22 announced that a glitch prompted the agency to erroneously send payments to the Medicare beneficiaries to reimburse them for nearly $50 million in premiums. The affected Medicare beneficiaries also received letters from the Social Security Administration that erroneously said the agency will no longer deduct their monthly prescription drug benefit premiums from their Social Security checks.
CMS later sent the affected Medicare beneficiaries a second letter to inform them of the glitch -- which occurred when the agency updated SSA about beneficiary information -- and inform them that they must return the erroneous reimbursements to the federal government.
McClellan said that most of the Medicare beneficiaries affected by the glitch received the erroneous reimbursements by direct deposit, although some received checks (California Healthline, 8/24).
The erroneous reimbursements averaged $215, although some exceeded $500.
CMS said that Medicare beneficiaries on Tuesday can begin to call a toll-free number to receive information about whether the glitch affected them. According to the letter, to repay the federal government, affected Medicare beneficiaries can:
- Write "VOID" on the face of the check from the federal government and mail the check to a P.O. Box address specified in the letter;
- Mail a personal check or money order made payable to Medicare with a notation of the their Medicare account numbers; or
- Call the toll-free number to arrange an electronic transfer from their bank accounts to the federal government.
CMS officials said that the agency will not call Medicare beneficiaries about the glitch. CMS officials also said that, to prevent fraud, Medicare beneficiaries should not provide personal information to callers who claim to offer assistance with repayment to the federal government.
According to the AP/Chronicle, lawmakers from both parties "have expressed frustration with the premium reimbursement" and asked McClellan "for a detailed report on how the error occurred and how the agency will try not to let it happen again." In addition, some lawmakers have requested congressional hearings to address the issue.
McClellan said, "We're adding some additional checks on the data before it goes over" (AP/San Francisco Chronicle, 8/29).
In related news, "political officials" have alleged that the Pharmaceutical Research and Manufacturers of America gave money to the U.S. Chamber of Commerce to support an advertising campaign that praises senators and House members who voted for the 2003 Medicare law, the AP/San Jose Mercury News reports (Espo, AP/San Jose Mercury News, 8/25). The $10 million campaign was launched in July and includes radio and television ads (California Healthline, 7/31).
According to the AP/Mercury News, "officials who described PhRMA's involvement said they did not know whether the industry had given the Chamber money to cover the entire cost of the ads and other elements of an election-year voter mobilization effort or merely a portion." The campaign ads are airing in 10 states or congressional districts and have been removed in other areas because of errors, the AP/Mercury News reports.
An ad supporting Rep. Steve Chabot (R-Ohio) was removed because he voted against the 2003 Medicare law, and ads supporting Reps. Michael Fitzpatrick (R-Pa.), Mike Sodrel (R-Ind.) and Dave Reichert (R-Wash.) were removed after Democrats noted that the lawmakers were not in Congress when the law passed, according to the AP/Mercury News (AP/San Jose Mercury News, 8/25).
In other Medicare news, HHS inspector general Daniel Levinson in a report released on Wednesday questioned the legitimacy of a one-year research program conducted by CMS in which the federal government and beneficiaries paid oncologists a total of about $275 million to report information on chemotherapy side effects that might lead to improved care for cancer patients, the AP/South Florida Sun Sentinel reports. Under the program, the federal government paid $130 each time oncologists reported the information on the pain, fatigue and nausea experienced by Medicare beneficiaries who underwent chemotherapy.
In addition, Medicare beneficiaries had to pay $26 each time oncologists billed the program for the reports. About 90% of eligible oncologists participated in the program, and participants received a median of $23,000 each. However, some program participants received more than $270,000, and one received $625,803.
According to the report from Levinson, the information on chemotherapy side effects collected through the program was "unreliable" because of "numerous anomalies and gaps in the data and collection methods," and most oncologists "did not believe it would lead to quality improvements for patients or produce any useful research findings" (Freking, AP/South Florida Sun-Sentinel, 8/29).
Adherence to hospital quality of care measures under a three-year CMS demonstration project could prevent more than 5,000 deaths and save $1.35 billion annually, according to a study released on Thursday by Premier, a group of not-for-profit hospitals responsible for the collection of data for the project, the Fort Worth Star-Telegram reports. Under the project, CMS pays higher reimbursements to hospitals that meet 33 quality of care measures (Perotin, Fort Worth Star-Telegram 9/1).
For the study, researchers analyzed about 224,000 medical records of patients hospitalized for pneumonia, coronary artery bypass graft surgery, heart attack, hip and knee replacement and heart failure (Dixon, Reuters, 8/31).
According to study, adherence to the quality measures for pneumonia, coronary artery bypass graft surgery, heart attack and hip and knee replacement patients would result in 5,700 fewer deaths, 8,100 fewer complications, 10,000 fewer hospital readmissions and 750,000 fewer days in the hospital. Adherence to the quality measures for heart failure patients would result in more complications but fewer hospital readmissions, the study finds (Fort Worth Star-Telegram 9/1).