Medicare drug plan hindered by technology woes

The implementation of Medicare's prescription-drug plan has hit a few bumps. Still, millions of Americans are enjoying smooth access to the new benefit, according to the Health and Human Services Department.

Computer glitches, incomplete medical information and jammed telephone lines were among the reported problems that surfaced in the first days of Medicare's plan, which was enacted in 2003 and fully implemented Sunday. Some beneficiaries in Maine, Massachusetts, New York and elsewhere reported that their information could not be found in the Medicare database.

Furthermore, some pharmacists who accessed the database to determine patient eligibility for the benefit reported slow computer responses. They had to call into overloaded phone lines at healthcare plans and to the Centers for Medicare and Medicaid Services to verify eligibility.

"What we experienced on the first day [Monday] were high volumes" of requests, said Robert Borchert, a spokesman for NDCHealth, a healthcare technology company that handles the electronic verification of program beneficiaries for Medicare.

Borchert said the company made adjustments to the hardware and computer codes to rectify the problems. Improvements to response times were seen later on Monday and Tuesday, with a return to normal query responses by Wednesday. "We are at sub-second response times," he said.

As far as other errors within the database, "That is a different issue," he said. Once individuals are enrolled in the drug program with their healthcare plans, the insurers must submit the electronic files to CMS so they can be put in the agency's format. The files then are submitted to NDCHealth. "It is a continuing process," Borchert said.

Given that 21 million people now have access to the benefit, the few problems have not overshadowed the program's early success, said Peter Ashkenaz, a spokesman for CMS. Moreover, due to the "surge in enrollment" in December, human error in completing enrollment forms and the time it takes to process the forms, some beneficiaries had not received their confirmation letters or plan cards in time for the transition.

In Maine, a separate issue hindered the transition for thousands of individuals. Two days before the program's start, Sen. Olympia Snowe, R-Maine, sent a letter to CMS Administrator Mark McClellan, alerting him of reported "inaccurate and incomplete information" of Maine beneficiaries in the computer database.

"The CMS database does not include correct information on roughly half of the approximately 45,000 dual-eligible Medicare beneficiaries," Snowe wrote in the letter. Furthermore, she said some 35,000 low-income people eligible for assistance and also enrolled in the state's pharmacy assistance program had not been validated in CMS' database.

Ashkenaz said the root of the problem in Maine was that "the state had decided" to move its beneficiaries into the Medicare plan Dec. 29. "Needless to say, that was the end of December."