HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Sunday, December 12, 2004

CMS Hotline Frequently Gives Wrong Answers

One of the GAO reports mentioned below made front-page news in today's New York Times and papers across much of the country picked the story up.  The story cited a 29% error rate on consumer calls and (citing a different report) an astonishing 96% error rate on billing questions from physicians:

Medicare's toll-free telephone line, one of the main vehicles for disseminating information about new prescription drug benefits and drug discount cards, gives accurate answers less than two-thirds of the time, Congressional investigators say.

In a test of the service, the investigators, from the Government Accountability Office, found that 29 percent of callers received inaccurate answers, while 10 percent got no answers at all. 

Use of the phone line is expected to soar in coming months as the elderly sort through a complex array of new insurance options and benefits.

Discount cards, available since May, can significantly reduce drug costs. But many beneficiaries hesitated to sign up, saying they were puzzled by the multiplicity of options. A government Web site compares drug prices under various cards, but many beneficiaries say they are not adept at using computers and find the site difficult to navigate.

In response, Bush administration officials say that beneficiaries can get all the information they need by calling 800-MEDICARE (633-4227). But the people who answer those calls are themselves often confused, the Government Accountability Office said, in an evaluation required by Congress under the new law.

"We found that 6 out of 10 calls were answered accurately, 3 out of 10 calls were answered inaccurately and we were not able to get a response for 1 out of 10 calls," the report said.

In another recent report, the accountability office found that Medicare provided even less accurate information to doctors who inquired about the proper way to bill for treating Medicare patients.

In response to 300 test calls, the accountability office said, customer service representatives gave correct and complete responses to only 4 percent of the billing questions. About 54 percent of the answers were simply wrong, and 42 percent were incomplete or partly correct, it said.

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