点击显示 收起
July 10, 2006 -- Telephone centers set up to answer questions about MedicareMedicare prescription drug benefits are providing mostly inaccurate and incomplete information to callers, a government report concluded Monday.
The call-in lines are supposed to serve as a key contact point between private insurance companies offering Medicare's drug program and beneficiaries. Both the companies and the government have relied on the lines -- operated by private insurance companies -- as a primary way to keep consumers informed about a wide array of options under the drug program.
But the study, issued by the nonpartisan Government Accountability Office (GAO), found that two-thirds of inquiries to call centers of 10 of the largest prescription drug plans were answered with incorrect or only partial responses.
The report also found wide variation in the accuracy and consistency of the answers provided by call-in centers.
The report is the second to question the quality of consumer information under Medicare's Part D prescription program, which began offering benefits for the first time on May 15.
Another report issued around that time found similar shortcomings at the government's 800-MEDICARE call center, though officials said they had already corrected the problems by the time the report was released.
Rep. Henry Waxman (D-Calif.), ranking member of the House Government Reform Committee and a long-time critic of the program, called the results "inexcusable."
"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," said Waxman, one of six Democrats who requested the study.
Medicare Reaction
Leslie V. Norwalk, acting deputy director of the Center for Medicare and Medicaid Services, tells WebMD that not all of GAO's questions to call-in centers were relevant to real beneficiaries.
"As a general rule we're pleased with the plans' performance and where we haven't been we've been pretty pointed in what we need corrected in order for the plan to continue in the program," she says.
The GAO report says its investigators placed 864 calls in March to help lines run by sponsors of the 10 largest private Medicare prescription drug plans. The agency praised the timeliness of responses, noting that 96% of calls were answered within five minutes.
The report says that typical questions about plan prices or out-of-pocket expenses were inconsistently answered. Accuracy and completeness of information in answering inquiries ranged from 20% to 60%, though only one insurer had an accuracy and completeness rate above 50%, according to the GAO.
Insurance Industry Reaction
The insurance industry lobbying group in Washington disputed the findings, saying that the study scored plans on information that in some cases they are forbidden to discuss under regulations.
"This report is a missed opportunity by the GAO to create an informed and accurate record of beneficiaries' experiences with Medicare Part D and will be misused by opponents of the program," Karen Ignagni, CEO of America's Health Insurance Plans, said in a statement.
GAO investigators said their questions reflected those asked by many beneficiaries and that Medicare officials had agreed were legitimate. "We maintain that our methods are sound and that our findings are accurate," the report states.
Enrollment for Part D's first year closed in May, though the Bush administration agreed to waive late-enrollment penalties for low-income beneficiaries.
SOURCES: Government Accountability Office Report: "Medicare Part D: Prescription Drug Plan Sponsor Call Center Responses Were Prompt, But Not Consistently Accurate and Complete," July 10, 2006. Rep. Henry Waxman (D-Calif.). Karen Ignagni, CEO, America's Health Insurance Plans. Leslie V. Norwalk, acting deputy director, Center for Medicare and Medicaid Services.