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Medicare Drug Program News
Few of Marketing Materials Used by Private Drug
Plans Meet Medicare Guidelines
Report by HHS says Centers for Medicare & Medicaid
Services gave faulty instructions
Sept. 5, 2008 - Nearly 85% of the marketing
materials used by private prescription drug plans to reach Medicare
beneficiaries do not fully meet
CMS guidelines, according to a report released Thursday by the
HHS
Office of Inspector General,
CQ HealthBeat reports. The report found that CMS provided the drug
providers with faulty sample documents on which they were to base their
marketing materials.
The sample documents omitted information on the
low-income subsidy program and some information about how the enrollment
process works.
In addition, the report found that 79% of marketing
materials for plans associated with specific pharmacy companies did not
tell consumers that they could continue to get their medications from
other pharmacies, and 42% did not inform consumers about how they could
get their prescriptions filled if the usual mail order option was
unavailable.
According to CQ HealthBeat, some of the errors in
the marketing materials were "relatively minor," including the wrong
size font in footnotes (Armstrong, CQ HealthBeat, 9/4).
The report found that some marketing materials
failed to provide an alphabetical index of the drugs a plan covered (Freking,
AP/San Francisco Chronicle, 9/5).
The report also found a year-and-a-half delay by
CMS to review many of the materials given to consumers in 2006 (CQ
HealthBeat, 9/4).
Medicare officials said that many of the issues
cited in the report "are not atypical during the initial start-up of a
new program" (AP/San Francisco Chronicle, 9/5).
CMS spokesperson Jeff Nelligan said, "CMS has
generally already implemented the [OIG] recommendations," adding,
"Oversight and review is focused on the requirements that are most
critical to beneficiary understanding."
The report found that CMS has since corrected the
sample documents and has finished the review of many delayed marketing
materials (CQ HealthBeat, 9/4).
Senate Finance Committee Chair Max Baucus (D-Mont.) said, "It's
unconscionable that CMS has let the insurance industry's materials,
including essential items like pharmacy directories and summaries of
benefits, fail to properly inform seniors 85% of the time" (AP/San
Francisco Chronicle, 9/5).
He added, "This report reveals a near-total failure
by CMS, where officials have insisted that they can regulate the
marketing of plans to seniors as well as or better than experienced
state insurance agencies," but the "evidence now shows that's not the
case." Baucus in a statement said, "You'd better believe the Finance
Committee will move to make sure seniors get better services one way or
the other" (CQ HealthBeat, 9/4).
>> The report is available
online (.pdf).
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