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Medicare Officials Order End to Instructive ServicesBy ROBERT PEAR, NY Times
January 25, 2003 WASHINGTON, Jan. 24 — Running short of money, Medicare officials have ordered immediate cuts in a wide range of services that provide information, advice and assistance to Medicare beneficiaries. In a bulletin to Medicare contractors, the government told them to halt outreach and education activities intended to inform millions of beneficiaries of their rights under the federal health insurance program. Contractors said the cuts would make it more difficult for elderly people to obtain information and assistance, just as President Bush announces proposals for huge changes in Medicare. The bulletin, issued on Dec. 24 and signed by two senior officials at Medicare headquarters in Baltimore, told contractors how to save money in dealing with beneficiaries. Under the heading "Customer Service Plan Functions," the directive said, "All tasks associated with this activity, as outlined in the fiscal year 2003 budget and performance requirements, are to be stopped, effective with the receipt of this memorandum." Contractors, generally insurance companies, review and pay Medicare claims for the government. Beneficiary education has always been one of their most important duties. Medicare officials said the contractors would still answer telephone calls and written inquiries from beneficiaries. But the contractors have halted efforts to educate beneficiaries through newsletters and visits to centers for the elderly, health fairs, hospitals and other sites. Representative Sherrod Brown, Democrat of Ohio, said he had received complaints from constituents. "The cuts are eroding not only the quality of customer service," Mr. Brown said, "but also confidence in the traditional Medicare program." The cutbacks came to light as Mr. Bush rehearsed his State of the Union speech, which will most likely propose vast changes in Medicare, including new benefits for prescription drugs and a greater role for private health plans. Preliminary reports of his proposal touched off a furor among Democrats. Senator Tom Daschle of South Dakota, the Democratic leader, said Mr. Bush would "coerce seniors" to join private plans to receive drug benefits. Senator Jeff Bingaman, Democrat of New Mexico, said: "That idea is not worthy of debate. The president needs to go back to the drawing board." The chairman of Aetna, Dr. John W. Rowe, praised the proposal, saying older Americans would benefit from the competition among insurers. "We would be happy to participate" in the program envisioned by the president, Dr. Rowe said. An administration official said tonight that Mr. Bush's advisers had held a "damage control meeting," where they tried to figure out how to answer criticism of the proposal. In interviews this week, Medicare contractors in Florida, New York, North Dakota, Ohio, Pennsylvania and Washington State said they were cutting service to beneficiaries because of the instructions. Medicare officials said the contractors would continue to answer beneficiaries' calls and written inquiries. In the services being halted, Medicare contractors told patients about new benefits and advised them on topics like appealing a denial of a claim, selecting a nursing home, obtaining discounts on prescription drugs, reporting Medicare fraud and what to do in the event of an overcharge by a doctor or a hospital. Medicare officials said the cuts were necessary because Congress had not decided how much money would be available to administer Medicare this year. The Department of Health and Human Services, like much of the government, has been operating under stopgap spending bills since Oct. 1. Spending is frozen at 2002 levels. The contractors' work has increased, with explosive growth in Medicare claims, which now number more than one billion a year. But the contractors' budget, $1.6 billion in federal money last year, is about the same as it was in 1992. Thomas L. Grissom, director of the Center for Medicare Management, a unit of the Department of Health and Human Services, said the December bulletin was "causing concern to some Medicare beneficiaries and providers." Mr. Grissom said the directive was needed "to stay within our budget restrictions." Victoria Menichillo, a spokeswoman for HealthNow, a Medicare contractor that serves 1.8 million elderly and disabled people in upstate New York, said: "The new policy will clearly have an adverse impact on beneficiaries. It eliminates a source of reliable and timely information about Medicare. All our beneficiary outreach and education operations have ceased, in accordance with the instructions from Washington." Ms. Menichillo said members of Congress should be prepared for an increase in calls from elderly constituents who are seeking information and assistance. J. Brian Herrmann, a spokesman for Highmark Inc., a Blue Cross and Blue Shield plan that pays Medicare claims in Pennsylvania, said: "We have ceased publication of our quarterly newsletter, stopped meetings of our beneficiary advisory committee and halted presentations at hospitals and senior citizen centers. These were all valuable activities." Lydia S. Rogers, who coordinates Medicare activities at Blue Cross and Blue Shield of Florida, said federal Medicare officials had made clear that "they don't want us to initiate enhancements of customer service that had been planned for this year." Copyright
© 2002 Global Action on Aging
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