§1395w–154 Improved Medicare Prescription Drug Plan and Ma–pd Plan Complaint System

Summary

The Secretary of Health and Human Services must create and keep a well-known, easy-to-use system that collects and stores complaints about Medicare Advantage prescription drug plans (MA–PD) and standalone prescription drug plans. The system must take complaints by phone, letter, email, or any other way, including from HHS regional offices, the Medicare Beneficiary Ombudsman, subcontractors, carriers, fiscal intermediaries, and Medicare administrative contractors, and keep the records until each complaint is resolved. The system must be able to report problems, start interventions and monitoring for serious issues, and help improve plan quality. The Secretary must also make a model electronic complaint form and put it on the front page of Medicare.gov and the Medicare Beneficiary Ombudsman website. Each year the Secretary must send Congress a report that analyzes complaint numbers and types, where they occur, how quickly agencies or plans respond, and how complaints were resolved. Definitions: MA–PD plan — Medicare Advantage plan with drug coverage; prescription drug plan — standalone Medicare drug plan; Secretary — Secretary of Health and Human Services; system — the complaint system described above.