Drug Benefit Help Line Offers Inadequate Answers

Government telephone operators who help beneficiaries with questions about the Medicare prescription drug benefit often give callers incorrect or incomplete information, according to a Government Accountability Office report released on Wednesday, the Washington Post reports (Connolly, Washington Post, 5/4). GAO investigators posing as Medicare beneficiaries made 500 calls to 1-800-MEDICARE, asking five questions a total of 100 times each (Freking, AP/San Francisco Chronicle, 5/3).

Phone operators gave inadequate or incorrect answers about one-third of the time, the report says. According to the Post, the "quality of service varied widely" depending on the questions.

For example, operators correctly answered 90% of questions about which beneficiaries qualified for discounted drug plans but only correctly answered 41% of questions about which plans are least expensive and most appropriate for an individual, the report finds (Washington Post, 5/4). Additional findings include:

• Operators answered questions completely and accurately 67% of the time (Heil, CongressDaily, 5/3).
  
  
• Operators often told callers that they required a Social Security number to answer questions, when general information can be provided without the number (Washington Post, 5/4).
  
  
• About 75% of the calls were answered within five minutes, but more than one in 10 calls took more than 15 minutes to answer, and one caller was placed on hold for 54 minutes (AP/San Francisco Chronicle, 5/3).

The GAO report also evaluates Medicare's written promotional materials and the program's Web site (Washington Post, 5/4). The report says the written materials are accurate but difficult to understand.

The materials do not comply with "about half of the 60 commonly recognized standards for good communications" and are written above the fifth-grade reading level, at which 40% of seniors read, according to the report (CongressDaily, 5/3). The Medicare Web site also is confusing, and it leads some beneficiaries to give up before completing the sign-up process, according to the report (Washington Post, 5/4).

The report says Medicare has "not ensured that its communications to beneficiaries and their advisers are provided in a manner that is consistently clear, complete, accurate and usable." It adds, "Six months have passed since these materials were first made available to beneficiaries, and their limitations could result in confusion among those seeking to make coverage decisions" (AP/San Francisco Chronicle, 5/3).

The report says that Medicare officials faced a "tremendous challenge" in developing and distributing the materials but adds that "it is unlikely that the problems identified in this report could have been corrected yet given their nature and scope."

House Energy and Commerce Committee ranking member John Dingell (D-Mich.), one of the Democrats who requested the report, said, "The president should extend the May 15 enrollment deadline and not penalize seniors for the administration's errors." He added, "Seniors can't make good choices if they can't get good information, ... [a]nd these problems confirm that this privatized prescription drug plan is inherently too complicated" (CongressDaily, 5/3).

CMS Administrator Mark McClellan said, "I'm very concerned about the report being incomplete, inaccurate and out-of-date." McClellan said the help line has received 22 million calls in the last six months and that caller surveys show 87% are satisfied with their experience (Fagan, Washington Times, 5/4). In addition, 97% of callers found the operators courteous and patient, McClellan said (Carey, CQ HealthBeat, 5/3).

HHS Secretary Mike Leavitt said wait times for the help line are "now down to two or three minutes." He said, "It was too long, and we responded. I can say with some satisfaction that things have improved dramatically" (AP/San Francisco Chronicle, 5/3).

Leslie Aronovitz, director of the GAO division that prepared the report, said the administration was aware of the investigation but did not know which callers were from GAO. She added that investigators "bent over backwards to try to give them as much leeway as we could" (Washington Post, 5/4).

The report is available online. Note: You must have Adobe Acrobat Reader to view the report.

Leavitt at a Senate Labor-HHS Appropriations Subcommittee hearing on Wednesday said that the May 15 deadline will not be extended, CongressDaily reports.

"We believe a deadline is necessary and that it is working," Leavitt said. He said an additional two million beneficiaries will sign up for drug coverage by May 15, and 90% of beneficiaries who could get coverage will have it by the deadline.

Sen. Richard Durbin (D-Ill.) said, "People need more time. Come May 15, the law will impose a penalty on those who couldn't get this done" (Povich, CongressDaily, 5/4).

In related news, Democrats on the House Ways and Means Health Subcommittee "forced" a second day of hearings on the drug benefit, saying they wanted to hear more testimony about the program. Under House rules, the minority party can request additional witnesses if they do so before the close of a hearing, which Democrats did on Wednesday.

In a letter to subcommittee Chair Nancy Johnson (R-Conn.), the Democrats wrote, "At a minimum, we would likely invite: a state Medicaid director, an executive with UnitedHealthcare and/or Humana, an analyst with the Government Accountability Office, a representative of the Office of the Inspector General, a Medicare expert from the Kaiser Family Foundation, a beneficiary membership organization, a witness to address retiree coverage issues and perhaps others."

They add, "Many of these witnesses were requested, but rejected, by the majority" (CongressDaily, 5/4).

CBS' "Evening News" on Tuesday reported on the GAO investigation of the Medicare prescription drug program (Andrews, "Evening News," CBS, 5/2). The complete segment is available online in RealPlayer.