Medicare overhaul fraud rules, Wyden urge delay in Medicare website overhaul


Medicare overhaul fraud rules, Wyden urge delay in Medicare website overhaul.

Sens. Jeff Merkley and Ron Wyden, D-Ore., said Wednesday they are urging the Trump administration to delay implementation of a Medicare enrollment website overhaul to address key problems with the new Medicare Plan Finder tool they said would make it harder for seniors to compare insurance and prescription drug plans.

The letter was sent in anticipation of a high volume of inquiries from beneficiaries during an already chaotic time. Medicare Open Enrollment begins on Tuesday, Oct. 15, and is an important time for beneficiaries to make coverage decisions and shop for supplemental Medicare Advantage and Part D prescription drug plans.

In their letter to Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma, the senators shared the serious concerns about the proposed website redesign conveyed by several dozen Oregonians who assist Medicare beneficiaries in Oregon.

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“Advocates have shared that the new system does not allow seniors to view a side-by-side comparison of their prescription drugs like the previous plan finder tool,” the senators wrote.

“The new system also does not save the prescription information for future use, requiring beneficiaries to re-enter prescription drugs every time. For beneficiaries who take anywhere from 1 to 25 different prescription medications, this can mean 90 minutes or more added to their enrollment time.

“While the effort to overhaul and improve the online experience for the nation’s 60 million Medicare beneficiaries is needed, the later-than-expected rollout, functionality, and monitoring of the new Medicare Plan Finder tool raise significant concerns,” the senators continued.

Any problems with the proposed Medicare Plan Finder tool would have heightened consequences in Oregon, where 45% of Medicare beneficiaries select Medicare Advantage Plans — the third highest Medicare Advantage enrollment in the nation.

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In 2020, Medicare Advantage plans for the first time will have the flexibility to offer new, supplemental benefits. These additional options will require careful review and objective information so beneficiaries may select plans that best meet their needs.

To ensure that Medicare beneficiaries receive the information and support they need to select an optimal plan, the senators asked:

Is it possible to maintain the current legacy system until January 1, 2020?

What process, if any, has CMS used to solicit feedback from SHIPS [State Health Insurance Programs] and assisters along with beneficiaries to test the new tool and develop a Frequently Asked Questions (FAQ) brochure or similar resource?

What process, if any, has CMS developed for SHIPS and assisters to provide observations and other feedback to CMS regarding the new plan finder as open enrollment begins?

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What process does CMS have in place to monitor the rollout and any disruptions to the Medicare Plan Finder tool?

What procedures are in place to respond to potential site disruption, unexpected crashed or log-outs, and delays associated with creating new accounts or recovering passwords?

What contingency plans are in place to respond to capacity challenges that SHIPS, 1-800-MEDICARE, Medicare.Gov and other assisters may face due to the anticipated high volume of beneficiaries seeking assistance?

What monitoring will take place to identify and review enrollment patterns such as unusual spikes that might indicate inappropriate outreach or broker behavior? What monitoring exists to protect against adverse selection?

What process is in place to report and correct inappropriate outreach or broker behavior?


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