Two Democratic senators from Oregon want Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services (CMS), to address issues surrounding the launch of a new Medicare Advantage provider directory tool.
In a November 4 letter to Oz, Senators Jeff Merkleye and Ron Wyden expressed concern that the tool, intended to help seniors compare plans, may contain errors that could mislead beneficiaries and result in unexpected medical bills.
The provider directory is meant to show which physicians are in-network or out-of-network for specific plans. In August, CMS announced it would incorporate the Medicare Advantage provider directory information into the Medicare Plan Finder to make it easier for Medicare beneficiaries to shop for plans.
Merkley, the ranking member of the Senate Budget Committee, and Wyden, ranking member of the Senate Finance Committee, acknowledged CMS’ goal of improving plan navigation for enrollees, but they criticized the rushed rollout, citing reports of duplicative addresses and contradictory listings, such as providers appearing as both in-network and out-of-network. A Washington Post investigation found these inconsistencies during the first day of open enrollment for Medicare beneficiaries, raising questions about the accuracy of the tool.
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“For the nearly 34 million seniors currently enrolled in MA plans, choosing coverage is already a confusing and time-consuming process,” the senators wrote. They argued that the tool’s inaccuracies could exacerbate existing challenges for seniors and people with disabilities.
CMS reportedly informed Medicare Advantage organizations that enrollees could switch plans within three months if they were misled by provider directory errors. But the senators said they haven’t seen similar guidance communicated to beneficiaries nor had CMS provided a method for verifying network information.
Merkley and Wyden requested answers from CMS by November 17, including why the agency stopped plans to build a national provider directory; who approved the accelerated timeline for the temporary Medicare Advantage-only directory tool before open enrollment; and what steps are being taken to correct known errors.