On November 27, the Wednesday before Thanksgiving, Centers for Medicare and Medicaid Services (CMS) issued a blog entitled “We’re Heading into the Last Week of Medicare Open Enrollment – Don’t Miss Out on Your Chance to Find Better Coverage.” In addition to encouraging Medicare beneficiaries to explore their plan options in the remaining days before the annual enrollment period expires on December 7, one of the main themes of the blog was touting the updated Medicare Plan Finder (MPF).
In the second paragraph of its blog, CMS complains about media reports outlining problems with the Plan Finder, but fails to acknowledge that there have actually been any problems (other than receiving bad data from Medicare Advantage (MA) and Part D prescription drug plans):
CMS has been distressed to see media coverage talking about “glitches” or “malfunctions” in the Plan Finder. Let’s be clear: the new Plan Finder has experienced no outages since it was launched. It displays the most current and accurate information on premiums, deductibles and cost sharing that Medicare Advantage and Prescription Drug Plans provide. That information changes frequently because plans regularly update drug formularies and renegotiate drug prices. That’s good for beneficiaries and for the Medicare program.
The Center for Medicare Advocacy acknowledges that the new Plan Finder hasn’t experienced “outages” – but there certainly have been ample problems with the MPF, including many that were shared directly with CMS by multiple and diverse stakeholders. Such complaints have not only come from consumer advocates, but also Medicare counselors, U.S. Senators, Part D plans, state insurance commissioners, insurance brokers and others. An Appendix, below, lists some of the stakeholder statements and media reports about Plan Finder issues since August.
Feedback Provided to CMS
Even before the new Plan Finder was unveiled at the end of August, it was clear that there were going to be problems relating to the timing of the updates and the lack of a back-up system due to a change in federal contractors. For example, on the day the new MPF was released -August 27, 2019 – the Center or Medicare Advocacy sent a joint letter to CMS with the Medicare Rights Center, Justice in Aging, and the National Council on Aging letter expressing concerns about the roll-out of the updated MPF, and to revisions to Medicare’s marketing guidelines.
Numerous other stakeholders have also weighed in, expressing concerns about the timing and function of the new Plan Finder, including the National Association of Health Underwriters (NAHU), on September 17, and the National Association of Insurance Commissioners (NAIC), on October 16 (see Appendix).
Since the introduction of the new Plan Finder in August, CMS has continued to make improvements, based, in part, on feedback from SHIPs, advocates, and numerous others. CMS has communicated updates to SHIPs and others, and continues to solicit feedback about the MPF both before and during the current enrollment period, which expires December 7.
In addition to structural issues with the Plan Finder, it became apparent that there was erroneous data and information on the site. More than “glitches” often inherent when a new system is first debuted, those who counsel Medicare beneficiaries began to see significant problems across the country. As referenced in the Appendix, media reports emerged that highlighted “errors” in the MPF “that do not match with the insurance company websites” (Record Searchlight (10/11/19)); “various changes — and glitches […that] caused incomplete or incorrect results to be generated” (CNBC (10/15/19)); the website can “produce drastically inflated costs for some drugs, incorrect premiums for low-income people, and other ‘worrisome’ results [ … and costs for low-income subsidy (LIS) enrollees] are not being accurately reflected in the plan finder” (North Carolina Health News (10/22/19)); “a number of errors with the premiums reported for various health plans […] including instances when all options were listed as charging no premium when that is true only for a subset of health plans” and “showing wrong information about drug formularies” and “information about premiums and out-of-pocket costs doesn’t match data the state agency receives directly from insurers” (Star Tribune (11/20/19)); the Plan Finder “‘continues to produce flawed results,’ including inaccurate premium estimates, incorrect prescription drug costs and inaccurate costs with extra help subsidies” (ProPublica (11/25/19)); and “inconsistent drug prices for the same plan and different versions of the lists of drugs covered by that plan” (AARP (11/27/19)).
Just today, the Center has been contacted by an elder law attorney in Maryland who, working with her 79 year old client who wanted to disenroll from an MA plan and choose a Part D plan, was unable to create a MyMedicare account this morning, despite multiple attempts (over ten times) using the required data from her Medicare card, yielding the response “no such record can be found.”
Many of these problems have been reported directly to CMS – at CMS’ request – by SHIPs and others serving Medicare beneficiaries. According to ProPublica, prior to its November 27th blog, CMS “acknowledged in a statement that some problems have been reported”; the same article notes that the administrator of the Nebraska SHIP program “flagged about 100 errors with the new tool since Oct. 1” including one client’s drug costs being “off by $2,000.” A Minnesota counselor with whom the Center for Medicare Advocacy has spoken reports having submitted more than 100 emails herself to CMS’ designated address for MPF issues and problems. SHIPs across the country have been sending CMS evidence of errors and incorrect information. Advocacy organizations have also provided feedback to CMS electronically and in person.
CMS’ inability to admit that there have been problems with the Plan Finder undermine and undercut the hard work of Medicare counselors and advocates across the country who have dutifully tried to adapt to the new platform, provide needed assistance , and report problems to CMS. Many Medicare beneficiaries have likely made choices about their Medicare Advantage and Part D plans based on inaccurate information, yet CMS is publicly saying that this enrollment period has been no different from any other. This is simply not true.
Special Enrollment Period (SEP)
Medicare rules generally restrict peoples’ ability to change Medicare Advantage and Part D plans to certain times of the year. While those enrolled in MA plans have an additional opportunity to change plans between January and March through the Medicare Advantage Open Enrollment Period, those enrolled traditional Medicare and a stand-alone Part D plan (PDP) do not have this option. Further, problems arising from coverage choices based on erroneous information might not arise or be identified until later in the year.
There are certain instances in which Medicare rules allow for individuals to make changes to their MA or Part D plans outside of the prescribed enrollment periods – certain triggering events give rise to a Special Enrollment Period (SEP) right. See, e.g., Medicare Managed Care Manual, Chapter 2 – “Medicare Advantage Enrollment and Disenrollment” – Section 30.4.2 – Special Enrollment Period (SEP) for Contract Violation and the Medicare Prescription Drug Benefit Manual, Chapter 3 – “Eligibility, Enrollment and Disenrollment” – Section 30.3.3 – SEPs for Contract Violation.
Although CMS publicly failed to acknowledge any problems with the Plan Finder, the November 27 CMS blog does mention the availability of a Special Enrollment Period (SEP):
Of course we want to ensure that beneficiaries are confident in their decisions and happy with the coverage they choose. We have protections such as Special Enrollment Periods in place if something happens to shake that confidence. As is the case every year, our call center representatives and staff caseworkers can help beneficiaries throughout the year if they believe they made the wrong plan choice because of inaccurate or misleading information. This process isn’t new, but this year we’re doubling down on ensuring that it’s a simple and painless experience for beneficiaries. Our staff is trained and ready to help any beneficiary who needs it. All they need to do is call 1-800 MEDICARE. Again, we’ve always had a Special Enrollment Period for people who think they made a wrong choice due to inaccurate information.
Although it is unclear what CMS means by “doubling down” on providing access to an SEP, we are hopeful that additional steps will actually be taken to both publicize the availability of an SEP and make it easier for people to obtain one. But failing to acknowledge that there have been significant problems this year, including erroneous information – and instead referring to an SEP “we’ve always had” – minimizes the errors upon which people made decisions that are not in their best interest. This may serve as a deterrent to seek an SEP for those who are unsure about, don’t recall or don’t have evidence about inaccurate information they obtained through the Plan Finder. Further, what message is CMS leadership sending its employees who must process and issue decisions concerning request for SEPs? If the message is “nothing happened” or “nothing to see here” will that deter CMS staff from providing needed SEP relief to beneficiaries?
The day before CMS’ November 27 blog, an article about the Plan Finder published by AARP noted that CMS is “talking to stakeholders such as Medicare advocates and counselors on a regular basis” yet states that “[t]he Centers for Medicare and Medicaid Services (CMS) says the issues that have come to the agency’s attention so far ‘are not inaccuracies but rather user error or confusion’” [emphasis added].
In other words, instead of acknowledging problems with the Plan Finder, including inaccurate and incomplete information, CMS instead is blaming problems on people who are trying to use the new system. Instead, CMS should publicly acknowledge there have indeed been problems with the Plan Finder. Otherwise, beneficiary efforts to obtain an SEP based upon inaccurate information will be undermined.
There are many dedicated people at CMS who are trying their best to serve Medicare beneficiaries, including by addressing problems with the Plan Finder. Statements from CMS leadership that fail to acknowledge any fault or problem – no matter how minor – is more than just an example of “gaslighting” the public. Such statements mislead the public and undermine the ability of people to exercise a meaningful right to obtain help, including a Special Enrollment Period. CMS should operate in good faith, own up to problems with the new Plan Finder, and openly offer needed relief.
December 2, 2019 – D. Lipschutz
Partial list of articles/statements re: MPF since August 2019:
- California Health Advocates: “CHA Voices Concerns on the New Medicare Plan Finder Tool” statement concerning a letter to CMS (8/26/19) sent by California Health Advocates (CHA), a non-profit organization that supports the SHIP in California, known as Health Insurance and Advocacy Programs (HICAPs), raising concerns about privacy issues, changes in the way searches of information will be stored, extra time that will be required of SHIP counselors and the resulting impact on their ability to serve as many people as possible, among other issues.
- “Beneficiary Advocates Raise Alarms Concerning Roll-Out of New Medicare Plan Finder and Revision of Medicare Marketing Rules” – Joint Press Release by Center for Medicare Advocacy, Medicare Rights Center, Justice in Aging and National Council on Aging (8/27/19) highlighting letter to CMS which stated, in part “significant concerns about the roll out process. In particular, we find it troubling that the new MPF’s late August release may not give third-party assisters, like State Health Insurance Assistance Programs (SHIPs), adequate time to learn the new tool before Fall Open Enrollment begins. Coupled with recent legislative and regulatory changes set to take effect this year, the truncated MPF launch timeline is likely to generate demand for enrollment assistance that these chronically underfunded programs are unable to meet.”
- “Medicare races to fix flaw in new tool that lets millions of seniors find cheap drug plans” by Robert Weisman, Boston Globe, 9/10/19 – “The plan finder upgrade has emerged as a bugaboo for counselors at free state Medicare assistance programs operated out of senior centers across the country. […] The advisers worry that any delay in adding the total-cost feature to the new tool will greatly add to the time it takes them to assist beneficiaries, limiting the number of people they can help.”
- National Association of Health Underwriters (NAHU) letter to CMS (9/17/19) “Many of our agents and brokers have tested the new Medicare Plan Finder and find that does not provide satisfactory information and available plans to consumers in order to make informed decisions about their coverage options.”
- “Enrolling in a Medicare prescription drug plan? You’ll need extra time, advocates say” by Kristen Jordan Shamus, Detroit Free Press (9/29/19)
- “The new Medicare Plan Finder is here — and it’s causing some confusion” by Phil Moeller, Considerable.com (10/4/19) “Given these problems, I strongly urge Medicare beneficiaries to hold off making 2020 plan enrollments until the beginning or even middle of November. Your choices for 2020 plans will still be effective next Jan. 1. And waiting to decide will give Medicare more time to get it’s [sic] act together.”
- “As Medicare Enrollment Nears, Popular Price Comparison Tool Is Missing” by Susan Jaffe, Kaiser Health News (10/8/19)
- “Wyden, Merkley Urge Administration to Put the Interests of Seniors Above Insurance Companies” – Press Release issued by Senators Wyden and Merkley (10/9/19) highlighting a 10/3/19 letter send to CMS expressing “significant concern with the later-than-expected roll-out, functionality and monitoring of the new Medicare Plan Finder tool. […] Several dozen Oregonians who assist Medicare beneficiaries in making coverage choices have reached out to our offices with significant concerns about the roll out process.”
- Updated Medicare Plan Finder ‘a mess,’ so here’s some help” by Margaret Beck, Record Searchlight (10/11/19) “We’re finding inadequate functionality such as inability to do detailed comparisons, print or save reports and errors that do not match with the insurance company websites. Most agents and our professional associations are begging to reopen the old platform.”
- “As Medicare open enrollment nears, seniors may find redesigned website is a work in progress” by Steve Twedt, Pittsburg Post Gazette (10/14/19) Advocates note that “the overarching concern is that the new website has not been sufficiently road-tested ‘so people’s critiques and experiences could be taken into account and updated, and not five days before the start of open enrollment.’”
- “Medicare open enrollment is underway. Here’s what’s new and what to watch out for” by Sarah O’Brien, CNBC (10/15/19) “The updated version, which became available to users in late August, was met with criticism due to various changes — and glitches — that caused incomplete or incorrect results to be generated. While the Centers for Medicare and Medicaid Services has deployed many fixes in the wake of the negative feedback, it’s uncertain whether more tweaks are in store or if users will continue running into issues. “The intentions were good, but the timing was terrible,” said Danielle Roberts, co-founder of insurance firm Boomer Benefits in Fort Worth, Texas.”
- National Association of Insurance Commissioners (NAIC) letter to CMS (10/16/19) written “to support the concerns expressed by state regulators, consumer advocacy groups and industry representatives regarding the new Medicare Plan Finder (Finder).”
- “Cortez Masto Urges CMS to Address Medicare Website Concerns” Press Release issued by Senator Cortez Masto (10/17/19) highlighting letter sent to CMS “expressing concerns with the readiness of the Plan Finder website […] recent reports indicate that problems with the new website could leave consumers with misleading or incorrect information about plan cost and structure
- “Seniors signing up during Medicare open enrollment hitting glitches” by Thomas Goldsmith, North Carolina Health News (10/22/19) “A newly revised Medicare sign-up page can produce drastically inflated costs for some drugs, incorrect premiums for low-income people, and other “worrisome” results, say North Carolina health officials who work to make sure people over 65 get appropriate benefits.” “One issue has arisen for people of low income and limited means who are eligible for “extra help” under the program. “Those costs are not being accurately reflected in the plan finder,” statewide SHIIP director Melinda Munden said.”
- “Minnesota groups report errors in Medicare website” by Christopher Snowbeck, Star Tribune (11/20/19) “Counselors who help seniors consider Medicare insurance options say they have found a troubling number of inaccuracies on a federal government website for making health plan choices” including “a number of errors with the premiums reported for various health plans […] including instances when all options were listed as charging no premium when that is true only for a subset of health plans”; also “showing wrong information about drug formularies” and “information about premiums and out-of-pocket costs doesn’t match data the state agency receives directly from insurers”
- “Medicare drug plan finder can steer seniors to higher costs” by Ricardo Alonso-Zaldivar, Associated Press (including Houston Chronicle) (11/21/19) “Medicare’s revamped prescription plan finder can steer unwitting seniors to coverage that costs much more than they need to pay, according to people who help with sign-ups as well as program experts.”
- “The $11 Million Dollar Medicare Tool That Gives Seniors the Wrong Insurance Information” by Akilah Johnson, ProPublica (11/25/19) includes a “Medicare consultant” who found that MPF reflected that one plan covered all of her client’s drugs, but verification with the plan’s website found this not to be the case; in late October, the state of Nebraska “temporarily shut down a network” of volunteer advisors for a day because “miscalculations offered through [the MPF] were so worrisome”; EnvisionRx, a Part D prescription drug plan, “sent an email to brokers nationwide recommending that they not use [MPF] because of incorrect estimates on drug prices and patient deductibles”; Minnesota’s Association of Area Agencies on Aging stated in a November 14 news release that the MPF “‘continues to produce flawed results,’ including inaccurate premium estimates, incorrect prescription drug costs and inaccurate costs with extra help subsidies.” Further, CMS “acknowledged in a statement that some problems have been reported”; the administrator of the Nebraska SHIP program “flagged about 100 errors with the new tool since Oct. 1” including one client’s drug costs being “off by $2,000”
- “Medicare Prescription Plan website isn’t working right” by Delaware News Desk, Dover Post (11/16/19) Delaware Insurance Commissioner issues a consumer alert “Throughout this year’s open enrollment period, which ends Dec. 7, the Department of Insurance has received numerous complaints about the tool and anticipated prescription drug costs.” Complaints include “If a resident enters multiple medications, they may receive search results for plans that do not cover all of the prescriptions entered.”
- “Medicare Enrollees Should Double-Check Drug Plan Prices” by Dena Bunis, AARP (11/27/19) highlights ongoing problems as identified by advocates, including “inconsistent drug prices for the same plan and different versions of the lists of drugs covered by that plan”
- “Medicare Plan Finder Woes Get National Coverage” by Allison Bell, ThinkAdvisor (11/27/19) – “State insurance regulators and nonprofit health advocates have started to get large-scale, national media coverage for a problem that Medicare plan agents and brokers have been talking about for weeks: The government’s recently updated Medicare Plan Finder is not working very well.”