Some Drug Plans Missed Deadline for Explaining Coverage Changes
Medicare beneficiaries who did not receive timely information about benefit and cost changes for their Medicare prescription drug plans will have until Feb. 15 to select coverage for 2007, Reuters reports (Reuters, 12/29/06). Beneficiaries had until Dec. 31, 2006, to enroll in or change Medicare drug plans, although administration officials had urged beneficiaries to act by Dec. 8, 2006, to avoid problems.
Federal officials told private insurers that sponsor Medicare drug plans that they had to send "annual notice of change" documents to beneficiaries by Oct. 31, 2006, informing them of any changes to their plans (Pear, New York Times, 12/27/06).
UnitedHealth Group, one of the largest sponsors of Medicare drug plans, and possibly other insurers did not send the documents on time, acting CMS Deputy Administrator Herb Kuhn said. About 250,000 beneficiaries were affected and will have until Feb. 15 to make changes to their drug plans, Kuhn said (Reuters, 12/29/06).
CMS spokesperson Jeff Nelligan said the extended deadline applies to beneficiaries who did not receive the documents by Nov. 15, 2006, the start of the open-enrollment period (Erikson, Arizona Daily Star, 12/28/06).
UnitedHealth spokesperson Peter Ashkenaz said that about 200,000 of the insurer's enrollees did not receive the documents by Oct. 31, 2006. Ashkenaz said the documents were delayed because some of the notices contained erroneous information that had to be corrected and because there was "a fire that delayed production" at a facility that printed the documents (New York Times, 12/27/06).
Kuhn said CMS is working to identify other insurers who might not have sent the documents on time (Reuters, 12/28/06).
Nelligan said, "There could be penalties for plans that did not send out the annual notice of change on time" (New York Times, 12/27/06).
CMS sent a letter to insurers that sponsor Medicare drug plans notifying them that they have until Jan. 5 to inform affected beneficiaries of the extended deadline, Nelligan said (Querna, Bergen Record, 12/29/06).
Drug plans reported other problems in the last days of the open-enrollment period, the Times reports. Some insurers said they have not received guidance from the government on how to calculate late-enrollment fees for beneficiaries.
Under the drug benefit, beneficiaries who are eligible to join a plan but choose not to do so must pay a permanent 1% increase in their premiums for each month of delayed enrollment once they do sign up. Insurers have sought guidance on whether the federal government will calculate the late-enrollment penalty or whether the plans should determine it themselves based on the number of uncovered months reported by the beneficiary.
In addition, Medicare and the Social Security Administration still are working to resolve problems related to withholding premiums from beneficiaries' Social Security checks. Some insurers reported long delays in corrections to Medicare records that determine the payments, the Times reports (New York Times, 12/27/06).
The AP/Houston Chronicle on Monday examined beneficiaries' opinions about the Medicare drug benefit after one year of the program. According to the AP/Chronicle "millions of seniors ... say [that] they are happy with the benefit" and that it has saved them money. However, many beneficiaries "believe the program could be improved," particularly citing the so-called "doughnut hole" coverage gap (Freking, AP/Houston Chronicle, 1/1).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.