Senate Aging Committee ranking member Gordon Smith, R-Ore., is on a campaign to improve telephone customer service at HHS. In preparation for an appearance by Centers for Medicare and Medicaid Services Acting Administrator Kerry Weems before the committee, Smith conducted his own investigation of the service provided by 1-800-MEDICARE, CMS's help line. Weems' testimony Thursday involved CMS's activities monitoring nursing home quality.
When it was his turn to question Weems, Smith said his staff made 15 test calls to 1-800-MEDICARE last week, asking basic questions including "What is the difference between Medicare Part D and Medicare Advantage?" and "What are the enrollment periods for these plans?"
"The answers were all over the board and they were often inaccurate," Smith said. Weems replied, "That's unacceptable," and promised to look into the matter.
A Smith aide said the swiftest connection to a customer service representative was 14 minutes, and one staffer was on hold for half an hour. One staffer posing as a senior was told, wrongly, that people enrolled in Medicare's Part D prescription drug program can switch plans midyear if they do not like their choice at open enrollment.
Another customer service representative asked only for the caller's ZIP code before naming one prescription drug plan as "best" for the region, Smith's aide said. Standard protocol for recommending specific drug plans would involve, at minimum, learning the types of medicines a caller is taking. Smith's staff investigation coincided with the open enrollment period for Medicare's prescription drug program, which began Thursday.
In 2004, GAO said CMS's primary contractor training customer-service representatives was following the necessary standards for training them, but the training might not be giving all representatives the knowledge and skills to answer questions accurately.