Senior Advocacy Groups Allege Inaccuracies in CMS's Medicare Handbook

From RADAR on Medicare Advantage

CMS during its recent Medicare Advantage and Prescription Drug Plan Spring Conference & Webcast touted various "consumer-friendly" improvements it is making in advance of the 2020 MA Annual Election Period. But some senior advocacy groups are concerned that language contained in the new handbook may inappropriately steer beneficiaries away from fee-for-service Medicare and favor MA as an option.

In a May 15 letter to CMS Administrator Seema Verma, three organizations — the Medicare Rights Center, Justice in Aging and the Center for Medicare Advocacy — charged that the handbook "suggests" that MA is the less costly option and pointed out that various factors "can affect the relative affordability" of MA for beneficiaries.

The groups also observed that the handbook "fails to make clear a key distinction" between the two programs. Moreover, the draft handbook in two separate places attempts to characterize prior authorization requirements in MA as a benefit rather than a restriction on access to services.

Speaking at the spring CMS conference, Erin Pressley of the Creative Services Group within the CMS Office of Communications said the agency aims to deliver "accurate and balanced content," with the "goal of being neutral."

She added that CMS is making changes to the handbook after it performed targeted testing of coverage choice information presented in the handbook and the Initial Enrollment Period (IEP) Direct Mail Package. The research observed that seniors around the time of enrollment are inundated with information and prone to confusion. Moreover, they often don't realize that they must make a coverage choice beyond qualifying for Medicare and choosing whether to accept or decline Part B.

Based on its research, CMS will update the 2019 handbook with refined checklists and flowcharts illustrating coverage choices and new content to more fully explain some aspects of the Medicare program, Pressley said.

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