Committee Wants GAO Investigation of Medicare Drug Plan Information;
'Aggressive marketing tactics used by Medicare
Advantage plans may be misleading senior citizens about the true cost
and scope of benefits'
Sen. Bill Nelson (D-FL)
Sen. Susan Collins (R-ME)
May 22, 2013 –
The bi-partisan leadership of the Senate Special Committee on Aging has
requested an investigation of pricing and coverage details presented by
sponsors of Medicare prescription drug programs on Medicare’s online
Part D. prescription drug plan finder. The committee will also hold its
own hearing today on the Medicare drug program, which is nearing its
Sens. Bill Nelson (D-FL) and Susan Collins (R-ME),
the chairman and ranking member, sent a letter yesterday to the
Government Accountability Office (GAO) asking for an examination of the
job the government is doing to ensure the companies are not running
afoul of Medicare marketing guidelines.
The lawmakers’ request was spurred, they report, in
part by a U.S. Department of Health and Human Services Inspector General
(HHS-OIG) report that found aggressive marketing tactics used by
Medicare Advantage plans may be misleading consumers about the true cost
and scope of benefits.
Approximately 38 percent of all Medicare
beneficiaries are enrolled in a Medicare Advantage plan that includes
drug coverage. But, for the remaining 62 percent enrolled in
stand-alone Medicare drug plans, no such study has been undertaken to
examine the accuracy and oversight of online marketing information these
seniors rely on to select their coverage.
“With more than $65 billion invested, and important
personal coverage decisions at stake, ensuring plan sponsor compliance
with fair marketing practices to seniors and the accuracy of the
information provided to beneficiaries electronically is essential for
both beneficiaries and the taxpayer,” wrote Nelson and Collins.
News of the request comes on the eve of a hearing
the committee will hold today that will take a broader look at issues
facing the Medicare prescription drug program as it approaches its
ten-year anniversary. Before Part D, about 30 percent of Medicare
beneficiaries lacked any drug coverage and many more had very limited
Today, ninety percent of Medicare beneficiaries have
comprehensive prescription drug coverage and nine out of ten say that
they are happy with that coverage.
The costs of the program are also far below
original projections. The hearing will focus on what is working well
in the program as well as on areas that are in need of improvement.
One issue Nelson intends to bring up at the hearing
is legislation he’s sponsored to end the practice of drug companies
charging the government more for prescriptions for low-income Medicare
beneficiaries who also qualify for Medicaid. Nelson, a sponsor of the
Medicare Drug Savings Act, believes passing the bill that require
manufacturers to pay the same rebates for dual-eligible beneficiaries in
Medicare Part D as they used to do in Medicaid would save the federal
government as much as $140 billion over ten years.
When Congress created the Medicare prescription
drug program in 2003, it allowed seniors to purchase coverage through
private insurers or other companies approved by Medicare. In 2010,
some 17.6 million older Americans were enrolled in stand-alone Medicare
approved prescription drug plans nationwide
Below are the details of today’s hearing and text
of the Nelson-Collins letter to the GAO.
SENATE SPECIAL COMMITTEE ON AGING
"Ten Years Later: A Look at the
Medicare Prescription Drug Program"
Margaret Woerner, Medicare Beneficiary and Helpline
Volunteer, Medicare Rights Center
> Jack Hoadley, PhD, Research Professor,
Health Policy Institute, Georgetown University
> Richard Smith, Executive Vice President
for Policy and Research, Pharmaceutical Research and
Manufacturers of America
> Robert G. Romasco, President, AARP
Letter to GOA
The Honorable Gene Dodaro
U.S. Government Accountability Office
441 G Street, N.W.
Washington, D.C. 20548
Dear Mr. Dodaro:
This fall will mark the tenth year since Congress passed the
Medicare Modernization Act, the landmark legislation that
established a voluntary outpatient prescription drug benefit
through private plans approved by the federal government.
Today, 49 million elderly and disabled beneficiaries will
have a choice of more than 20 stand-alone prescription drug
plans (PDPs) and multiple combination Medicare
Advantage-Prescription Drug plans (MA-PD) available in their
region. With more than $65 billion invested, and important
personal coverage decisions at stake, ensuring plan sponsor
compliance with fair marketing practices to seniors and the
accuracy of the information provided to beneficiaries
electronically is essential for both beneficiaries and the
The Medicare Part D program has grown significantly in size
and complexity since the first year of open enrollment
began. While ninety percent of seniors say that they are
satisfied with the Medicare Part D prescription drug
program, numerous independent studies demonstrate that
seniors continue to overspend on, and remain confused by,
their Part D plan options. Additionally, in the Office of
the Inspector General’s most recent compendium of
unimplemented recommendations, the Medicare Part D program
is cited as particularly vulnerable to fraud and abuse, and
program integrity investments in Part D in those areas of
the program that directly impact beneficiaries have been
To realize the benefits of expanded consumer information as
the program continues to grow, the data displayed on the
Plan Finder must be complete and accurate, and CMS must make
certain that plan sponsors observe the Medicare marketing
guidelines that safeguard consumer transparency. Such a body
of work studying the accuracy of plan information given to
Medicare Part D consumers is of critical importance in order
for Congress and the federal government to continue to make
targeted improvements that will help seniors to navigate and
choose the right coverage.
Therefore, we respectfully request that GAO conduct a
limited study prior to the start of this year’s open
enrollment period to examine the following:
1) Is the information on plans and drug pricing provided to
beneficiaries on the Part D Plan Finder accurate and
up-to-date? Is the data displayed in a way that it appears
consistent to beneficiaries? How has the Plan Finder
evolved, and what strategies could further improve
2) What certification process is in
place to ensure ongoing completeness of data in accordance
with federal regulation? Is CMS conducting adequate
oversight of private insurers’ compliance with information
provided to consumers?
3) Is current oversight focusing on the
transparency and marketing of plans to seniors adequate and
in accordance with CMS’ stated Medicare Marketing
Thank you for your attention to this
Bill Nelson Susan Collins
Chairman Ranking Member
You may be eligible for money damages if you owned or leased one of these VW, Porsche or Audi vehicles.
In the major scandal of 2015, Volkswagen cheated you and the world. They rigged diesel emission controls so you, nor regulators, would know how much pollution their cars were adding to our environment.
They were caught and have reserved $7.3 billion to help "make it right" with victims.
If you owned or leased one of these vehicles, contact us now.
Janicek Law attorneys are actively pursuing these cases against VW. Do Not Wait...