Government

Settlement reached in Part D lawsuit

NEWS IN BRIEF — Posted Nov. 2, 2009

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The Center for Medicare Advocacy announced on Oct. 23 that a settlement had been reached in Machado v. Sebelius, a lawsuit against two government agencies charging that premium withholding delays had an adverse impact on Medicare drug plan beneficiaries.

The Machado case was brought against the Centers for Medicare & Medicaid Services and the Social Security Administration by beneficiaries who experienced lengthy delays in having their Part D premiums withheld accurately, or in some cases not withheld, from their Social Security benefits. At the time the case was filed in 2007, a large number of people reported problems with erroneous premium withholdings, especially after switching drug plans, according to the Medicare advocacy center. Efforts made by CMS and SSA to improve withholding mechanisms since the lawsuit filing resulted in significant reductions in delays and errors.

Under the settlement, CMS customer service representatives are directed to advise people to call them back, or to call their Part D plan, if a withholding discrepancy is not addressed within 90 days. The representatives also are directed to inform beneficiaries of the date when they requested a change in withholding, if that date is in the CMS system. The agency has revised its operating procedures to prioritize and track the resolution of Part D premium withholding complaints through a special system.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2009/11/02/gvbf1102.htm.

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