Group Questions Referrals From Medicare Drug Hotline

The toll-free phone line Medicare has established to counsel beneficiaries about the program's new prescription drug benefit is referring up to 600 callers a day to a New York city based consumer group to answer the most basic questions, complained the group's president.

Robert M. Hayes of the Medicare Rights Center said that while his group has agreed to provide help to Medicare beneficiaries with complex cases, "they are sending us [beneficiaries with] basic questions about what plan to pick," Hayes said in an interview. "Clearly the operators are unable to help most people."

Centers for Medicare and Medicaid Services spokesman Gary Karr said that as a State Health Insurance Assistance Program, or SHIP, the Medicare Rights Center has agreed to accept funding from the government in return for helping beneficiaries understand the new benefit. SHIPs in general have received additional federal funds to provide such services this year and are experiencing increased call volume, Karr said.

"That's what they're there for. If they can't handle that kind of assistance they should let us know," Karr said of the center. "Despite their lawsuits and press releases, they do take money from the federal government to help people."

The Medicare Rights Center is one of several groups that has filed a lawsuit against the federal government charging that federal officials are not doing enough to protect individuals who are eligible for both Medicare and Medicaid but will receive their drug coverage under Medicare when the drug benefit begins next Jan. 1.

Karr disputed Hayes' estimate of the number of beneficiaries referred by 1-800-Medicare but Karr did not provide an alternative figure. Karr added that he has received many positive accounts of Medicare's own phone counselors providing assistance to beneficiaries looking for help understanding and enrolling in the new benefit. Karr also said he knew of no agreement between CMS and the center to limit referrals to only the most complex cases.

Separately Wednesday, Department of Health and Human Services Secretary Michael O. Leavitt urged seniors and their families to discuss the new drug benefit over the Thanksgiving holiday. The Friday after Thanksgiving should be a "National Day of Conversation" to help beneficiaries with the benefit, he said.

"If they need it, help them review drug plan options and decide which one to sign up for. I will talk to my family about Medicare prescription drug coverage and will help choose the plan that best meets their needs. I hope you will, too," Leavitt said in a statement.