Leading Democrats are pressing the Trump administration over the launch of Medicare's new provider directory tool.
Oregon Sens. Jeff Merkley and Ron Wyden wrote a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz, M.D., saying the "rushed" launch of the tool is "riddled with erroneous, conflicting and duplicative information."
The senators expressed concern that this could mislead seniors who are selecting their coverage through inaccurate information about plan networks, which could lead them to incur higher-than-expected medical costs and bills.
“While we appreciate CMS’ stated intent to help enrollees more easily navigate and choose a Medicare Advantage plan, we are concerned that this rushed rollout will mislead millions of seniors as they compare plans, and may cause seniors and people with disabilities to incur medical bills they reasonably believed would be covered,” they wrote in the letter (PDF).
The senators said media reports suggest CMS was set to build a broad, national provider directory that would simplify the experience for seniors across the board. However, the agency instead "rushed out a temporary MA–only version" that leans on a single vendor: SunFireMatrix, a technology company for the Medicare insurance market.
For example, the current tool will at times display certain providers as both in-network and out-of-network, or will display contradictory data about a specific plan.
Merkley and Wyden also note the CMS did reach out to managed care organizations to inform them of the new directory and to confirm that, should an individual sign up for coverage based on inaccurate details, they can switch plans within three months to address it.
However, the senators argue that no such outreach was made to enrollees themselves.
"Nor has CMS made clear how MA enrollees can verify accurate network information or how they may remedy a mistaken plan choice caused by the tool’s inaccuracies," the senators write.
They're seeking additional detail from the CMS about the timeline for the tool's launch along with whether and how the agency plans to conduct outreach to Medicare beneficiaries about the potential data inaccuracies.