The Centers for Medicare & Medicaid Services (CMS) recently released a fact sheet as well as a follow-up letter sent to the approximately 230,000 Medicare beneficiaries who erroneously received refunds of their Part D premiums as a result of a CMS processing error.  The CMS letter and fact sheet describe how future Part D premiums will be paid for this group of beneficiaries and how the beneficiaries should return the incorrect payments.  Unfortunately, the CMS letter fails to explain all of the options that may be available to beneficiaries who received a premium refund, including that they may request a waiver of repayment to CMS.

Returning the Incorrect Payment

The CMS letter informs each beneficiary of the exact amount of the incorrect payment CMS believes the beneficiary received.  The letter then describes different methods for returning the payment.  Payments are supposed to be returned to CMS by September 30, 2006.

·    Beneficiaries who received a check from CMS may mark the check “VOID” and return it to a designated post office box in California: Medicare-Drug Premium, P.O. Box 9058, Pleasanton, CA 94566-9058.

·    Beneficiaries may send a personal check or mail order, payable to “Medicare,” to the same designated California post office box.  CMS advises beneficiaries who choose this option to include on the check their name and the account number that appears on the letter.

·    Beneficiaries may call a specially-designated phone number, 1-866-292-8080, to request that the amount due be taken directly from their bank account.  The phone number is different from the Medicare hot line number, and, unlike the Medicare hot line, will only be open from 7 AM Eastern time to 6 PM Pacific time.

·    Beneficiaries may also call the special phone number if they believe that repaying the full amount would cause hardship and they want to establish a monthly payment installment schedule.  CMS stated in the letter to beneficiaries and on a call with state health insurance assistance programs (SHIPs) that payment installment schedules may extend for up to seven months.

CMS advises beneficiaries to contact the special phone number if they have already returned the payment. They are also advised to contact the special phone number, and not 1-800-Medicare, if they have questions. 

Requesting Waiver of the Overpayment

The CMS letter fails to outline another important option for Medicare beneficiaries.  In certain circumstances a beneficiary may be entitled to a waiver of the overpaid refund.  Waiver of the overpayment may be available to a beneficiary who was without fault in causing the overpayment and where repayment would be against equity and good conscience.

Beneficiaries who believe they meet the requirements for a waiver should request a waiver when they call the specially-designated phone number.  If they are told they cannot request a waiver or if the waiver request is denied, they should file an appeal

Contesting the Repayment Request

In addition, as indicated in the August 24^th Weekly Alert, some beneficiaries recently received refunds of Part D premiums to which they are entitled, either because they are not required to pay premiums or because premiums were otherwise deducted from their checks inappropriately.  The CMS letter fails to advise beneficiaries of the process to use to contest CMS’ request for a refund if CMS and a beneficiary disagree over whether the premium refund was erroneous. 

Beneficiaries who believe they are entitled to the refund payment they received should contact the specially-designated phone number and explain why they are not required to return the premium.  If a dispute persists they should contact their regional CMS office.

Paying Future Part D Premiums

The system error that resulted in the refund of premiums also terminated the affected beneficiaries’ requests to have Part D premiums withheld from their Social Security checks.  The CMS letter assures beneficiaries that their Part D coverage will continue.  Because Social Security will not be able to resume withholding premiums from Social Security checks until October, premiums for September will not be paid.  CMS indicates that “in most cases” premiums for both September and October will be withheld from the October checks.

If you or others you know are experiencing any issues regarding this erroneous premium refund and would like to share the story, please visit the FairMedicare.org “Share Your Story” page at http://www.fairmedicare.org/signUp.jsp?key=563.

---