Watchdog shares information with Congress about Medicare hot line woes

A staffer for the U.S. Senate called The Watchdog recently asking for a favor. The staffer at the Senate Special Committee on Aging was looking for Texans who are hopping mad about failures of the 1-800-Medicare telephone hot line.

We introduced the staffer to Wilma Frashier of Midlothian, who endured her own Wilma-in-Medicare-Wonderland fiasco last year trying to get her medical bills paid. Nobody would help until The Watchdog intervened.

Frashier told her story to the staffer.

"Basically, I told him that phone number is terrible, and getting through the voice menu is a joke," she says bluntly.

On Sept. 11, the committee held a public hearing in the historic Senate Caucus Room at the U.S. Capitol. Frashier didn’t testify in person, but her story helped make the case for Sen. Gordon Smith, R-Ore., who has been investigating 1-800-Medicare for more than three years.

"There are failures in the system we need to fix," said Smith, the panel’s ranking Republican, as he opened the hearing. Callers are "our country’s most vulnerable citizens. It is unacceptable to subject the sick, frail and elderly to hourlong waits, disconnected calls, endless loops of referrals and call transfers."

Smith’s staff tests the system with "mystery shopper" calls. They also conduct inspections of call centers, interview call-center employees and monitor phone calls in progress.

The senator listed other problems they found:

Confusing interactive voice menu options;

Jargon and error-filled scripts;

Training deficiencies;

Incorrect information routinely being dispensed.

Amazingly, customer-service reps provided incorrect information in every (yes, every!) test call made, he said.

Finding others like Frashier isn’t hard. Millions of callers, frustrated about wait times, hang up before receiving an answer to their question, according to a 2007 inspector general report. During one week examined by the inspector general last year, 44 percent of callers reported difficulty obtaining information.

Naomi Sullivan of California testified before the committee that she was improperly enrolled in a medical plan that meant her doctor’s visits would not get paid.

"I called 1-800-Medicare over a dozen times," she said. Sometimes, she was placed on hold for as long as 45 minutes, then she’d get transferred elsewhere, and her call was usually disconnected. Because she couldn’t afford a land-line phone, she ended up using up all her cellphone minutes.

She told the senators, "It got to the point where I couldn’t afford to make one more call to 1-800-Medicare. I just wanted to give up. I felt like less than nothing. I felt like the people at 1-800-Medicare had no interest in helping me."

The top administrator in charge of the phone line, Kerry Weems, who runs Centers for Medicare and Medicaid Services, said the line receives millions of calls. Average hold times, he promised, will drop to five minutes or less the rest of this year.

Advocates for seniors were fierce in their criticisms.

Michealle Carpenter of Medicare Rights Center said seniors are among the "most vulnerable to exploitation" and are often fraudulently enrolled in private Medicare programs. Getting out of these is tougher than necessary.

"Representatives are unable to answer even basic questions," she said.

Seniors dislike the voice-prompt menus, too.

"They say, 'I wish I could get a live person,’ " testified Tatiana Fassieux of California Health Advocates. "We are still dealing with [people born in the] 1930s and 1940s, seniors for whom technology is frightening."

John Hendrick of the Coalition of Wisconsin Aging Groups said buzzing on the phone line makes it difficult to hear. Representatives return calls but don’t leave their phone number, forcing seniors to call the 1-800 number and start all over again.

When seniors want to file a complaint, they are told to expect a call back. "Our experience is those calls never come," he said.

Fixes offered by witnesses include:

Create an oversight office to supervise private contractors who run and staff call centers;

Increase the number of call-center staffers, as well as their training time;

Help them become experts in Medicare rather than just search for a script to read from when answering questions.

The Watchdog checked with members of the North Texas congressional delegation for reaction.

Rep. Michael Burgess, R-Lewisville, said, "If any of my constituents have that problem, let me cut through the red tape and get the problem taken care of. They should come to my office, and we will help them. I am happy to do that."

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