Consumer Protections Sorely Lacking in Medicare

Consumer Protections Sorely Lacking for Older and Disabled Americans Enrolled in Medicare Private Drug Plans, Consumer Group Testifies

Legislation Needed To Ensure that Both CMS and Private Drug Plans Fulfill Congress’ Intent to Provide Meaningful Protections for People in Plans

Older and disabled Americans enrolled in Medicare private drug plans lack consumer protections needed to guarantee access to prescription drugs at affordable prices, the Medicare Rights Center testified today at a hearing of the U.S. House of Representatives Committee on Ways and Means Subcommittee on Health.

Problems continue to plague the Medicare drug benefit program eighteen months after it took effect, testified the Medicare Rights Center, a national consumer service group. Enrollees in the Medicare drug benefit, available only through private drug plans, are still having difficulty securing – and maintaining – enrollment in an appropriate Medicare private drug plan, accessing affordable medicines through the low-income subsidy known as “Extra Help,” and getting needed medicine through Medicare private drug plans.

“Congress must ensure that people with Medicare have due process protections that govern decisions made by the Centers for Medicare and Medicaid Services and Medicare private drug plans,” said Robert M. Hayes, an attorney and president of the Medicare Rights Center. “It’s common sense, basic fairness and a requirement of constitutional law.”

Several consumer issues beleaguering the Medicare drug benefit program were highlighted in testimony provided by Paul Precht, deputy policy director at the Medicare Rights Center, including: rampant computer system problems among Medicare, private drug plans and Social Security that cause problems with plan enrollment, plan premiums and low-income status; people with the right to disenroll from Medicare private health plans that include the drug benefit, such as victims of private plan marketing abuse, are waiting months to get their coverage corrected; low-income people who change drug plans discover that the subsidy is not in effect in the new plan; and the drug appeals process is cumbersome, unfair and vulnerable to obstructionist tactics by the Medicare private drug plans.

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