Senate Investigates Medicare Call Centers

Yesterday's Wall Street Journal reported on Senator Gordon Smith (R-OR) and his investigation into the quality of Medicare's call center brought to Capitol Hill. The call centers, run by Vangent, are under investigation because "In 50 test calls placed last month, wait times ranged from zero to 45 minutes, and six calls were disconnected while on hold. Call centers have provided at least one piece of incorrect information or been unable to provide a response to at least one question in 90% of test calls placed in the past year," reported the WSJ article. Vangent denies the allegations citing their high customer satisfaction percentages. What do you think of Senator Smith's investigation?

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Humana looses some Medicare Enrollees

As a result of premium bids that are higher than low income, government assigned members of Medicare, Humana expects to loose 10% of them at the beginning of 2009. However, according to the Wall Street Journal, they believe this could be positive for Humana due to the fact that higher prices would increase the bottom line, shares dropped 5% to $41.75 when it was announced that this could lead to a los of 380,000 eligible Medicare members. To ensure drug coverage for these dropped Medicare enrollees, the government will automatically re-enroll them in private drug care provider programs.

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Oversight in Medicare Drug Fraud

As reported in this Wall Street Journal article, the Government Accountability Office released a report stating that some insurers do not have “in place all the fraud controls they’re supposed to.” This means that some of them have not “met the requirements for employee training and internal monitoring and auditing. The GAO also stated that this oversight “risks significant misuse of funds in this $39 billion program.” Acting administrator for Medicare, Kerry Weems, has stated that he disagrees, however, has admitted the funding cap for the Medicare Integrity Program has, “seriously degraded [Medicare’s] ability to meet its responsibilities in combating fraud abuse.”A copy of the full report can be found here.