As discussed in a recent CMA Alert, the Center or Medicare
Advocacy joined Medicare Rights Center, Justice in Aging and National Council
on Aging in writing to the Administrator of the Centers for Medicare &
Medicaid Services (CMS) to express concerns about the roll-out of the updated
Medicare Plan Finder (MPF), publicly released on August 27, 2019, in addition
to revisions to Medicare’s marketing guidelines.
Among the concerns noted in the joint letter, sent the same day
that the updated Plan Finder was issued, the 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.” The Annual Coordinated Election Period (ACEP), between October 15th
and December 7th, is the time period during which Medicare beneficiaries can
make coverage elections effective January 1st (this period is often referred to
as the Open Enrollment period).
The letter continued: “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.” Further, the current
“legacy” version of MPF will not be available starting next week (October 1st).
Thus, apparently due in part to issues relating to CMS’ current contract to
administer the MPF, there will be no back-up available for this enrollment
period.
Since the roll-out of the new MPF, Medicare advocates and
assisters continue to test the system in order to learn how to use it and
troubleshoot any problems prior to the upcoming ACEP. As noted in a recent Boston Globe article, Medicare assistors have identified
flaws, including the lack of a total out-of-pocket cost calculator that was a
feature of the “legacy” version.
Updates from CMS
Over the last couple of weeks, CMS has provided some updates
regarding further updates to the MPF, including materials made available on its
National Training Program website, which includes Top 10 Q&As on the new Plan Finder, a one
page infographic and recorded versions of webinars
discussing the new MPF.
CMS has indicated that further extensive enhancements will be made
to the MPF when 2020 Medicare Advantage (MA) and Part D plan information is
posted to the website, which in past years has been around October 1st.
Here are some of the additional updates provided by CMS:
·
Drug
Lists – many SHIPs and other
assistors help people do searches of Part D plans using lists of drugs that
could previously be saved on the website without having to create a MyMedicare
account. Due to a change in the contractor administering the MPF, CMS initially
said that such lists would no longer be available, but more recently note in
the Q&A: “We are working to extend access to any drug lists created in the
old Plan Finder through the end of the 2019 Open Enrollment.”
·
Total
Out-of-Pocket Drug Costs –
the ability to calculate projected total out-of-pocket drug costs was a feature
of the old “legacy” plan finder that was not included the updated version. In
the Q&A, CMS states “we have always planned to include the option to sort
plans based on Total Annual out-of-pocket costs by Open Enrollment, and
development of that feature is on track.”
While further improvements to the new MPF should certainly
continue to be made, such enhancements made at the same time that 2020 plan
information is made available will further strain SHIPs and other programs as
counselors try to learn and adapt to the updated updates. As noted in the joint
letter referenced above, we urge CMS to mitigate any adverse consequences of
these continual changes by closely monitoring the roll out and functionality of
the new MPF tool and providing enrollment relief as needed.
Privacy Concerns
One of the concerns surrounding the MPF updates is that, as noted
above, in order to save a drug search, a MyMedicare account must be created for
an individual. These accounts include information about an individual’s medical
claims history. SHIPs have expressed concern about having access to and
retaining information about such private, protected health information. In
response to these concerns, CMS noted in its Q&A:
“How can SHIP counselors, agents and brokers (or
non-beneficiaries) help beneficiaries create accounts and compare/enroll in
plans without violating HIPAA requirements?
Beneficiaries who work with trusted counselors using the old
Medicare Plan Finder have always needed to share some sensitive personal
information if they want help conducting a personalized search or enrolling in
a plan. When using the new Plan Finder, counselors are expected to uphold the
same practices they currently have in place to ensure that any personal information
is kept safe and secure, and is used appropriately and only for the purpose
that it was offered and intended.”
Unfortunately, while SHIPs might express concern about access to
such information, others will seek it out. For example, a recent email solicitation
sent to agents and brokers by an insurance marketing organization marked “For
Licensed Insurance Agent/Advisor Use Only. Not for General Public” markets a
proprietary tool for agents that is “Just in Time” for the upcoming enrollment
period. This tool will “Make Medicare sales easier than ever!” by “securely
import[ing] data directly from a client's medicare.gov account including:
·
Prescriptions filled
·
Pharmacies used
·
Healthcare providers
utilized”
The tool includes a “built-in auto-sync feature” that will
apparently keep such data “up-to-date.” The solicitation notes
“Imagine all your clients' Medicare data in one place.”
Pushing beneficiaries to establish MyMedicare accounts and in turn
incentivizing agents and brokers and others to use such accounts as a means to
counsel them about such options will invite misconduct. It doesn’t take much
imagination to see how such information can be used inappropriately, and not
“only for the purpose that it was offered and intended.”
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