Audit criticizes Medicare help line

Changes already in place at Pearson's Lawrence call center, company says

? The people who answer Medicare’s telephone help line gave accurate responses to questions less than two-thirds of the time, according to a congressional investigation made public Wednesday.

The worst performance came in response to a question about the $600 annual subsidy that goes with the new Medicare drug discount card for low-income people. Customer service representatives gave the wrong answer 55 out of 70 times, the Government Accountability Office said.

The 1-800-MEDICARE line is monitored by more than 3,000 customer-service representatives — most of them working for Pearson Government Solutions, whose largest call center is in Lawrence at the East Hills Business Park.

David Hakensen, a Pearson spokesman, cautioned against reading too much into the results, which were gleaned from 420 calls made by GAO in July, a month after the launch of the senior drug card program.

Pearson had experienced “a rapid expansion of call center staff” to brace for the new program, he said, and those employees had to be trained quickly.

“We had, really, unprecedented volumes that were coming into our call centers, so the snapshot probably isn’t totally accurate,” he said. “I think we received 3.8 million calls during May alone, and the contract was set up that we would get probably 7 million calls all year. You can imagine that getting 3.8 (million) in one month was much more volume growth than we were accustomed to.”

But Pearson, in concert with the department that set up the help line for the Department of Health and Human Services, has agreed to adjust training programs and change scripts to help improve service as outlined in the GAO report, Hakensen said.

“The recommendations have already been implemented,” he said.

Medicare chief Mark McClellan and other top health officials frequently tout the help line, (800) 633-4227, for Medicare recipients who want to figure out whether to sign up for a drug card. The phone lines were swamped when Medicare rolled out the card program in May, but average wait times during peak calling periods now are two minutes.

In July, GAO placed calls to the help line and evaluated responses about the drug card program and supplemental Medigap policies, as well as coverage for doctor visits, eye exams and the wheelchairs.

Investigators received accurate answers 61 percent of the time. Twenty-nine percent of the calls were inaccurately answered and 10 percent were not answered at all, GAO said.

By comparison, callers to the Internal Revenue Service got correct answers to their tax law questions 73 percent of the time, according to a 2003 study by Treasury Department investigators. The IRS itself estimated its employees answered 80 percent of the questions correctly.

Perhaps the most embarrassing gaffe involving the Medicare line concerned a question about power wheelchairs.

Confusing “trunk strength” — the term used in Medicare’s script to mean upper body strength — with the size of a car trunk, one operator “incorrectly explained that Medicare would only cover a power wheelchair if a beneficiary had adequate space to put it in the trunk of his car,” GAO said.

Patients without the strength to operate manual wheelchairs typically are eligible for electric models.

Pearson landed the contract for the Medicare help line in October 2002, when it announced the deal as one of two worth a combined $160 million over several years. The contract prompted Pearson to add a new 45,000-square-foot building in East Hills, bringing the company’s total space to 195,000 square feet.

Today, Pearson’s Lawrence operations have 1,837 employees.