“Yesterday’s comments by Secretary Leavitt were just the latest in a long line of miscues by the Bush Administration concerning the Medicare prescription drug program. Rather than accept responsibility for the fiasco of the program’s launch, the Administration is now saying that the onus of seeking repayments for being overcharged falls on seniors, and not on the insurance companies that wrongly overcharged recipients. This is simply outrageous, and I am demanding a retraction from Secretary Leavitt,” said Representative Allyson Y. Schwartz.

“HHS Secretary Leavitt maintained Monday that Congress does not need to step in to iron out problems with the new Medicare drug benefit, despite proposals by lawmakers to do so… Although the Administration is working to reimburse states that picked up the tab for those so-called dual eligible, Leavitt said it is up to the individuals who overpaid to recoup their money. ‘Anyone who paid a co-pay higher than they should have can apply for reimbursement from their plans,’[said Leavitt].”

Heil, Emily. “Leavitt: Congress Need Not Get Involved in Rx Plan Flap.” CongressDaily AM 14 February 2006. 3.

A copy of the letter Representative Schwartz sent to Secretary Leavitt follows below. For a PDF of the official signed letter, please contact Rachel.Magnuson@mail.house.gov.

February 14, 2006

The Honorable Michael Leavitt

Secretary

Department of Health and Human Services

200 Independence Avenue, SW

Washington, DC 20201

Dear Secretary Leavitt:

Yesterday, you stated that the Administration would not take any action to ensure reimbursement to individuals who were overcharged for Medicare-provided prescription drugs.  Instead, you said the onus was on individuals to petition their insurance plan for repayment.  Specifically, you told reporters, “Anyone who paid a co-pay higher than they should have can apply for reimbursement from their plan.”  Your approach to the over-billing of seniors and the disabled is deeply troubling and sends the absolutely wrong message to the private companies sponsoring Part D prescription drug plans.

First, commonsense dictates that seniors and disabled individuals, especially those with ailments such as limited mobility, dementia, or Alzheimer’s disease, should not be required to file paperwork to get their hard-earned dollars back, especially when they were wrongly charged.  Secondly, the Department of Health and Human Services’ own Prescription Drug Benefit Manual states that sponsors of Medicare Part D plans must have “a process to identify overpayments at any level within the sponsor’s network and properly repay such overpayments in accordance with CMS policy,” and “a process to identify improper denials of benefits, services, or enrollment at any level within its network and properly repay such overpayments in accordance with CMS policy,” (Chapter 9, Part D Program to Control Fraud, Waste, and Abuse, Page 19). 

Your lack of effort to address the over-billing of Medicare beneficiaries gives a free pass to the sponsors of Medicare Part D plans and violates the very guidance developed by your Department.  You must retract your comments and follow through on the direction previously provided to Part D plans in order to make it clear that the Administration is on the side of seniors and all Medicare beneficiaries, not private industry.  I look forward to your published retraction; as this will be a vital first-step in resolving the multitude of problems with Medicare Part D. 

                                                            Sincerely,

                                                            Allyson Y. Schwartz

                                                            Member of Congress

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