Michael Cooney
Senior Editor

Medicare computer system glitches causing widespread pain

Opinion
Apr 26, 20073 mins

Yet another glitch in Medicare system computers is starting to grab the attention of lawmakers. The latest problem involves Medicare taking extra money, sometimes for months in a row, from beneficiaries Social Security checks. A story today from The Hill says four Florida Democratic Representatives are pressuring the agency to explain the glitch, why it has taken so long to fix and why it takes so long to get the money returned to the beneficiaries. This problem is but one of a series of serious hiccups laid at the feet of Medicare’s computer system which is the responsibility of Medicare’s Centers for Medicare and Medicaid Services (CMS).

For example, last week the South Florida Sun-Sentinel reported seniors who belonged to certain HMOs last year have waited as long as 15 months for Medicare to pay refunds that are due to them – because of computer problems. In addition, CMS attracted a lawsuit by seniors’ groups last year when it accidentally sent refunds to some seniors who were not supposed to get them, then quickly sought to reclaim the money. And last fall Congress chided CMS saying its information security controls over the communication network were ineffective in protecting the confidentiality and availability of information and information resources. A GAO report said while CMS had many information security controls in place that had been designed to safeguard the communication network, key information security controls were missing. In addition, the controls that were in place had not always been effectively implemented.According to the Hill article, In the case of the Florida House members’ constituents, some beneficiaries joined managed-care plans through the Medicare Advantage program that offer a subsidy for their monthly premiums for Medicare Part B, which covers doctor visits. Even though such managed-care plans are covering all or part of these beneficiaries’ Part B premiums, the full amount was deducted from their Social Security checks. In some cases, the deductions continued for consecutive months. “We have constituents who have waited over 15 months for this problem to be resolved and to obtain their refunds,” the lawmakers wrote. The financial hardship facing the beneficiaries also varies, but most of the individuals have low incomes, the aides said. For its part CMS has not been all that forthcoming about the problems. What is known is that it signed a eight-year, $400 million contract with Lockheed Martin in 2002 to manage and operate CMS’s Information Technology Infrastructure. The computer systems include the agency’s mainframe and desktop computers, computer servers, voice communications infrastructure, help desk and other related services. The contract also allows CMS to provide additional funding for informational technology enhancements and engineering services that will help CMS meet its IT system architecture targets, the agency said in a release.