GAO Report on Medicare Customer Service Seriously Flawed and Inaccurate
Posted on: Monday, 10 July 2006, 15:00 CDT
WASHINGTON, July 10 /PRNewswire/ -- America's Health Insurance Plans (AHIP) today raised concerns about the accuracy and methodology of a new Government Accountability Office (GAO) report.
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"The GAO analysis of call centers scored Medicare Part D plans on their ability to discuss some information that customer service representatives (CSRs) are expressly forbidden from providing under regulations governing the program and responses to vague and misleading questions that are not representative of questions posed by real beneficiaries," said AHIP President and CEO Karen Ignagni. "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."
Since January, AHIP has been monitoring the performance of plan call centers. We know that the average time beneficiaries and pharmacists waited to speak to a customer representative was cut by 80 percent and 90 percent respectively. We are pleased that the Centers for Medicare & Medicaid Services (CMS) and now, the GAO, have confirmed these findings.
In addition, we also have surveyed our members to keep abreast of questions most frequently asked by beneficiaries. The majority of questions are about enrollment, coverage of drugs, copayments, premiums, and general Part D questions. The following questions are typical of the most frequently asked categories of questions.
* I recently enrolled, what is the status of my application? * My doctor prescribed a new medication, is it on the formulary? * I receive the Low Income Subsidy, what are my co-payment amounts? * When will my Social Security premium deduction be taken from my check? * Will I receive a plastic ID card? When will I receive it?
GAO surveyors asked none of these questions. Instead, the GAO chose to ask questions that in many cases should have been directed to CMS.
In addition, of most concern are questions that put CSRs in a position of steering beneficiaries to specific choices and counting a referral to other sources such as 1-800-MEDICARE -- which is required by regulation -- as an unsatisfactory response.
America's Health Insurance Plans -- Providing Health Benefits to More Than 200 Million Americans
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America's Health Insurance Plans
CONTACT: Mohit Ghose of America's Health Insurance Plans,+1-202-778-8494
Web site: http://www.ahip.org/
Source: PRNewswire
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