Medicare complaints draw little response from officials

It seemed simple enough to Barbara and Frank Meade.

Call the handy 1-800-MEDICARE number and report a health care contractor who appeared to be improperly billing the government.

The Meades weren't losing any money personally. Because Frank had been in the military, what Medicare didn't cover, Tricare, the military's health plan, did.

Still, it seemed like the right thing to do when they noticed that a medical equipment company was charging Medicare for a service it was not providing. Barbara Meade said she worried that, the way things are going with health care costs, Medicare won't be around for young people. Some government estimates have the program - which covers health care for people 65 and older - going broke by 2019 if something isn't done. A problem cited in one government study is Medicare's failure to monitor its contractors.

First, the Meades called the company about the apparent error. The company was charging for two kinds of oxygen systems when Frank was using only one. They noticed, too, that an affiliated company was billing for oxygen equipment for Frank's brother, Arthur, whose equipment had been returned.

But the charges kept coming.

Barbara Meade called 1-800-MEDICARE around 10:30 one morning in early June.

After 45 minutes of holding and being bounced around, she ended up with someone named Megan, who was "really very good. She was taking down all the information," Meade said.

Megan took down Frank's information, but she needed his brother's Social Security number before she could proceed with that case. Meade needed to call her brother-in-law to get it.

"How can I call you back?" Meade asked.

"Ask for the medical equipment department," she said Megan told her.

Meade called Medicare back around 1 p.m. but couldn't reach Megan. She told her story to someone else in the medical equipment department, only to be told "You need to talk to medical equipment department 3 and I'm in medical equipment department 2."

By that time it was after 2 in the afternoon.

Meade asked the Medicare worker on the line, "Are you sitting anywhere near someone by the name of Megan?"

"No."

He explained that there are Medicare offices all over the United States and Megan could be in any one of them.

Luckily, Megan had entered Frank's information in the computer, so there was just the matter of Frank's brother.

"At this, point, bang," said Meade, as she made an Archie Bunker-like motion of shooting herself in the head. "The next question was, 'What's Arthur's birthday?' "

Meade turned to her husband and asked whether he knew his brother's birthday and he said, "I don't know. I have a tough time keeping up with my own."

She knew she would have to call her brother-in-law again and start from scratch. At that point, she gave up.

She asked the Medicare operator what they do with the information they get. Do they red-flag the companies? Do they investigate all their contracts? "If I worked in your company, that's what I would do," Meade said she told him.

He told her he can't tell her what they do with the information.

"The trouble is when I called Medicare, I was the enemy," Meade said. "They all had their guards up."

Meade's experience with the 1-800-MEDICARE line is classic, said Judith Stein, executive director for the Center for Medicare Advocacy, a nonprofit based in Connecticut.

"We hear all the time from people who have called the 1-800-MEDICARE number and are quite unsatisfied with the results," Stein said. But even Stein was surprised, given that Meade was trying to report apparent overbilling, that Medicare workers didn't more effectively route her.

Medicare officials are looking into the Meades' case, said Lorraine Ryan, a spokeswoman for the Centers for Medicare & Medicaid Services.

Ryan said there were other numbers people could call if they suspected problems with Medicare, including the Senior Medicare Patrol at the Virginia Association of Area Agencies on Aging at 1-800-938-8885.

"But, bottom line, 1-800-MEDICARE ought to be a place where folks can get some guidance," Ryan said. "The system is big and people try their best....We hope people get the service that they need, and sometimes that doesn't happen."

Meade's efforts come as national leaders struggle with how to curb Medicare's costs while still providing essential care to the nation's seniors.

After a battle in Congress failed to avert it last week, a 10.6 percent reimbursement rate cut went into effect for doctors on July 1, a move that could exacerbate the problem of physicians not taking Medicare patients because the reimbursement doesn't cover costs.

A November 2007 U.S. Government Accountability Office report on how Centers for Medicare & Medicaid Services has managed spending found that the organization "did not fulfill critical contractor oversight responsibilities."

"We identified numerous questionable payments totaling nearly $90 million that represent potentially improper, unsubstantiated or wasteful payments," the report said.

Barbara Meade was not surprised to hear that. She wishes officials would make it easier for people like her to help. "Don't write off the senior citizens," she warned.

"We're very articulate and we're very alert. We read our bills and we see the flaws," Meade said. "But we have no one to talk to (and) say, 'Stop - we could save you millions of dollars.' "

Nancy Young, (757) 446-2947, nancy.young@pilotonline.com