Hello, Medicare?

Have you tried to call the 1-800-Medicare line lately? VGM’s John Gallagher has, and he didn’t get very far. In fact, he said of several attempts to register a complaint, calling in is a frustrating and time-consuming dead end.

“You are directed to at least 10 different stations,” Gallagher said recently. “The prompts are so ludicrous and then you get to a hold and you are on hold for 15 or 20 minutes. I have done it three times. I was hung up on twice, and when I did get somebody the third time, they put me on hold and never came back.

“It’s a great system CMS has devised.”

Gallagher thinks the number of prompts he went through might even be more than 10. “It just seemed to go on and on and on,” he said. “If I did get somebody, it was ‘Hold, please,’ and they never came back. Everything is set up to make sure you can’t get through.”

Gallagher, VGM’s vice president of government relations, brought up the experience because he thinks that could explain CMS’ assertion that it got only 43 complaints about competitive bidding out of 54,000 calls.

Industry advocates immediately questioned both figures, which agency officials included in a report on Round 1 at a meeting of the Program Advisory and Oversight Committee last month.

Cara Bachenheimer, senior vice president of government relations for Invacare and a former PAOC member, said it was unclear what the 54,000 represented — all competitive bidding calls from the nine Round 1 CBAs or other Medicare calls, or what? The way CMS defines a “complaint” is also unclear, she said. “Their definition of a complaint is not the same as ours.”

According to AAHomecare, CMS classifies some contacts, which can include calls about difficulty finding a contract provider or switching to less expensive equipment, as “inquiries.”

“We look at it as 54,000 people calling in to express concerns, and only in nine competitive bidding areas,” said the association’s Walt Gorski, vice president of government relations and a member of the PAOC. “Imagine what is going to happen as the realities of competitive bidding set in and there is a ten-fold expansion in the next round.”

Actually, Gallagher got farther than I did when I tried to call the Medicare help line. I don’t have a Medicare number (yet), and that’s the first thing the system asks for. Without one, I couldn’t get past the first prompt. That makes me wonder how family members or caregivers without a Medicare number, either the patient’s or one of their own, get through on the line, not just to complain about competitive bidding but to ask about anything.

The process could be especially burdensome for an elderly Medicare beneficiary who is ill or upset, Gallagher pointed out.

It seems like “they set up roadblocks to keep people from complaining,” he said. “If I am a caregiver, I should be able to call Medicare.”

He suggested that providers mention the boondoggle of a system to their legislators as they campaign for support of competitive bidding repeal bill H.R. 1041. “Ask your congressman to ask a staffer to contact the 800 help line,” he said.

Registering your own complaints about competitive bidding with your U.S. senators and representative — now there’s an important phone call you should definitely take the time to make.

View more competitive bidding stories.