Sep 15, 2006

CMS And SSA Heads Bite Dust In One Week -- Coincidence?

The following is an excerpt from The Hill:

Members of the Senate Finance Committee are keeping the pressure on the Medicare and Social Security agencies to fix a glitch that caused hundreds of thousands of beneficiaries to pay the wrong premiums.

The heads of both agencies met with the Finance Committee behind closed doors last week to go over their plans to rectify billing discrepancies that led to many Medicare enrollees owing unpaid premiums to the health-insurance companies providing their drug benefits.

Since meeting with Centers for Medicare and Medicaid Services (CMS) Administrator Mark McClellan and Social Security Administration (SSA) Commissioner JoAnne Barnhart last Thursday, several senators have expressed concern that the plans from agencies might be too harsh, especially for poorer beneficiaries.

These billing errors have brought renewed attention to the pitfalls inherent in rolling out the massive new Part D prescription-drug benefit, which has required the coordination of federal agencies and health insurers.

The administration has disclosed two separate billing problems in recent weeks that together affected an estimated 700,000 Medicare beneficiaries.

First, the administration revealed that 230,000 beneficiaries were accidentally sent refund checks that would have to be returned or repaid.

Later, the administration said that the wrong Medicare premiums had been deducted from Social Security checks sent to 400,000 to 500,000 beneficiaries throughout the year, and that in some cases no premiums at all had been paid for months.

The health plans that administer the drug benefit likewise have not been paid the premiums that CMS and the SSA should have been collecting and passing along. These health plans also will ultimately be responsible for recouping unpaid premiums.

The agency already has contacted the beneficiaries who received accidental refunds and is working individually to establish installment plans for those who may have spent the money already....

Earlier this week, Mark McClelland, the CMS Director, resigned. Now a replacement is named for Jo Anne Barnhart, the Commissioner of Social Security, with almost four months left on her term. All of this happens within a week at a time when frustration with the poor implementation of the Medicare prescription drug benefit is at its peak. Coincidence? While it may be obvious to those familiar with Social Security that the Medicare prescription drug benefit problems lie almost completely with CMS, this may not be at all obvious to Congress and the White House. Perhaps it was already clear that Barnhart was not going to be reappointed and this was merely a question of timing, but there is a strong possibility that Medicare Part D has something to do with what happened this week to McClelland and Barnhart.

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