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As discussed in a recent CMA Alert, the Center or Medicare Advocacy joined Medicare Rights Center, Justice in Aging and National Council on Aging in writing to the Administrator of the Centers for Medicare & Medicaid Services (CMS) to express concerns about the roll-out of the updated Medicare Plan Finder (MPF), publicly released on August 27, 2019, in addition to revisions to Medicare’s marketing guidelines.

Among the concerns noted in the joint letter, sent the same day that the updated Plan Finder was issued, the MPF’s “late August release may not give third-party assisters, like State Health Insurance Assistance Programs (SHIPs), adequate time to learn the new tool before Fall Open Enrollment begins.” The Annual Coordinated Election Period (ACEP), between October 15th and December 7th, is the time period during which Medicare beneficiaries can make coverage elections effective January 1st (this period is often referred to as the Open Enrollment period).

The letter continued: “Coupled with recent legislative and regulatory changes set to take effect this year, the truncated MPF launch timeline is likely to generate demand for enrollment assistance that these chronically underfunded programs are unable to meet.” Further, the current “legacy” version of MPF will not be available starting next week (October 1st). Thus, apparently due in part to issues relating to CMS’ current contract to administer the MPF, there will be no back-up available for this enrollment period.

Since the roll-out of the new MPF, Medicare advocates and assisters continue to test the system in order to learn how to use it and troubleshoot any problems prior to the upcoming ACEP. As noted in a recent Boston Globe article, Medicare assistors have identified flaws, including the lack of a total out-of-pocket cost calculator that was a feature of the “legacy” version.

Updates from CMS

Over the last couple of weeks, CMS has provided some updates regarding further updates to the MPF, including materials made available on its National Training Program website, which includes Top 10 Q&As on the new Plan Finder, a one page infographic and recorded versions of webinars discussing the new MPF.

CMS has indicated that further extensive enhancements will be made to the MPF when 2020 Medicare Advantage (MA) and Part D plan information is posted to the website, which in past years has been around October 1st.  Here are some of the additional updates provided by CMS:

  • Drug Lists – many SHIPs and other assistors help people do searches of Part D plans using lists of drugs that could previously be saved on the website without having to create a MyMedicare account. Due to a change in the contractor administering the MPF, CMS initially said that such lists would no longer be available, but more recently note in the Q&A: “We are working to extend access to any drug lists created in the old Plan Finder through the end of the 2019 Open Enrollment.”
  • Total Out-of-Pocket Drug Costs – the ability to calculate projected total out-of-pocket drug costs was a feature of the old “legacy” plan finder that was not included the updated version. In the Q&A, CMS states “we have always planned to include the option to sort plans based on Total Annual out-of-pocket costs by Open Enrollment, and development of that feature is on track.”

While further improvements to the new MPF should certainly continue to be made, such enhancements made at the same time that 2020 plan information is made available will further strain SHIPs and other programs as counselors try to learn and adapt to the updated updates. As noted in the joint letter referenced above, we urge CMS to mitigate any adverse consequences of these continual changes by closely monitoring the roll out and functionality of the new MPF tool and providing enrollment relief as needed.

Privacy Concerns

One of the concerns surrounding the MPF updates is that, as noted above, in order to save a drug search, a MyMedicare account must be created for an individual. These accounts include information about an individual’s medical claims history. SHIPs have expressed concern about having access to and retaining information about such private, protected health information. In response to these concerns, CMS noted in its Q&A:

“How can SHIP counselors, agents and brokers (or non-beneficiaries) help beneficiaries create accounts and compare/enroll in plans without violating HIPAA requirements?

Beneficiaries who work with trusted counselors using the old Medicare Plan Finder have always needed to share some sensitive personal information if they want help conducting a personalized search or enrolling in a plan. When using the new Plan Finder, counselors are expected to uphold the same practices they currently have in place to ensure that any personal information is kept safe and secure, and is used appropriately and only for the purpose that it was offered and intended.”

Unfortunately, while SHIPs might express concern about access to such information, others will seek it out. For example, a recent email solicitation sent to agents and brokers by an insurance marketing organization marked “For Licensed Insurance Agent/Advisor Use Only. Not for General Public” markets a proprietary tool for agents that is “Just in Time” for the upcoming enrollment period. This tool will “Make Medicare sales easier than ever!” by “securely import[ing] data directly from a client’s medicare.gov account including:

  • Prescriptions filled
  • Pharmacies used
  • Healthcare providers utilized”

The tool includes a “built-in auto-sync feature” that will apparently keep such data “up-to-date.”   The solicitation notes “Imagine all your clients’ Medicare data in one place.”

Pushing beneficiaries to establish MyMedicare accounts and in turn incentivizing agents and brokers and others to use such accounts as a means to counsel them about such options will invite misconduct. It doesn’t take much imagination to see how such information can be used inappropriately, and not “only for the purpose that it was offered and intended.”

September 26, 2019 – D. Lipschutz

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