Processing glitch mangles Medicare Part D premiums

If you have your Medicare Part D premiums automatically taken out of your Social Security check, you just might want to double-check that deduction.

A glitch in transferring funds from Social Security to the Centers for Medicare and Medicaid Services, the federal agency that oversees Medicare — dating back to at least September and possibly as far as 11 months — has failed to pay the premiums of as many as 700,000 subscribers nationwide, thousands of them in New Hampshire, to the federal government’s prescription drug program.

Letters obtained by NHBR Daily issued Oct. 30 by John R. Dyer, CMS’s chief operating officer, to all affected Medicare subscribers, described two different withholding errors:

• CMS failed to withhold either some or all of a person’s health and drug plan premiums for “a number of months.” Any needed funds were to have been withheld in the November Social Security payment.
• CMS was unable to process a person’s request to withhold a premium, and will now receive bills from their commercial plans their premiums. These individuals will receive a refund for all of the premiums withheld to date, but will then have to make payments directly to their plans.

Kurt Czarnowki, spokesperson for Social Security’s regional office in Boston, said he believed the issue seemed to be between Medicare and beneficiaries’ health-care plans, leading to the withholding discrepancy.

“Social Security is at the tail end of the process,” said Czarnowki.

Chris Dugan, communications director of Anthem Blue Cross and Blue Shield in New Hampshire, did not know the source of the error either. “It was some sort of snafu between Social Security and CMS,” he said. “It doesn’t appear to have happened to any one specific carrier.”

Dugan said 1,300 of Anthem’s New Hampshire members who subscribe to its Medicare Part D plans were affected.

“We are working diligently with CMS and Social Security to correct the issue,” he said.

Bob Carter of the Community Services Council of New Hampshire, an organization that assists individuals eligible for benefits from both Medicare and state-sponsored Medicaid, said he understood that when the amounts consumers directed to be withdrawn from their Social Security checks for the drug program premiums did not match the amount of the premium the computer system was expecting, “it kicked some folks out.”

Carter said he did not know how many New Hampshire people were affected by the glitch, but his office received very few calls from beneficiaries concerning their premiums.

“I can’t speak for SSA, since I work for CMS, but it’s my understanding that the problem was corrected in November, and we’ve received no further calls,” said Carter.

Sharon Torgerson of Harvard Pilgrim Health Care said her plan noticed something was amiss in June when it did not receive payments from CMS for about 400 of their members, 11 of whom are in New Hampshire.

“We notified CMS in July and were told by CMS it was the plans’ responsibility,” said Torgerson.

Cigna spokesperson Gloria Barone said she was not aware of the issue until a reporter contacted her.

“I’ve done some checking, and I’m not aware of any problems, but we will continue to investigate this issue,” said Barone.

Patricia Zeifang, director of marketing for Patriot Healthcare, said the provider’s legal counsel was looking into the issue.

While the glitch may have been running for possibly up to a year, many affected Part D subscribers will have significantly less time to pay up on delinquent premiums.

The already confusing issue becomes even more confusing because of its hit-or-miss targets.

Dugan said that Anthem members will have until March 2007 to pay any funds owed on their Anthem Medicare prescription plans.

Torgerson said Harvard Pilgrim began working with members individually over the summer to recover any missing payments and did not specify a deadline payment date.

“We’re waiting to make sure about seven of those affected have had their payment issues corrected,” she said.

The problem may actually be much wider than a missed payment or two. Helen Mulligan of the regional CMS office in Boston said there are a number of issues occurring with Medicare Part D payments and refunds.

“Some people didn’t have deductions taken out, some were supposed to get a refund and didn’t, one or two payments may have been missed and premiums were taken out in November,” said Mulligan.

Two other letters were sent to some Medicare Part D beneficiaries detailing other issues:

• Some received a refund as part of CMS computer system error and upon resuming the Part D premium withholding option, CMS failed to withhold Part C (Medicare’s managed-care plan) premiums for September and October. As a result, these beneficiaries will have their Part C premiums for September, October and their regular November premiums withheld from their November Social Security checks.
• Those who erroneously received a refund as well as CMS’s failure to withhold their September and October Medicare premiums, their November Social Security payment will reflect deductions for their September, October and November Medicare plan premiums.

In August, 230,000 Medicare Part D beneficiaries who pay premiums through a monthly deduction from their Social Security benefits were erroneously issued a premium refund of between $200 and $800.

A letter issued by the U.S. Department of Health and Human Services Secretary Michael Leavitt in early September was sent to these beneficiaries with directions on how to return the erroneous refund by Sept. 30.

Statements released by the national CMS office in Washington, D.C., said some of these issues were to have been corrected by the end of November, with some beneficiaries seeing deductions or refunds in their December Social Security checks.

Mulligan of local CMS office said she didn’t have a statistical break down on how many people were affected by the various issues in the state of New Hampshire, but she said she believes, as of November, some 50,000 nationwide may still be experiencing problems.

Like Anthem’s Dugan, Mulligan said that it was important to remind Medicare Part D beneficiaries that their coverage has not been affected.

If subscribers have any questions about their Medicare Part D payments, Mulligan recommended calling Medicare’s 24-hour hotline at 1-800-MEDICARE or 1-800-633-4227. — CINDY KIBBE

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