The Centers for Medicare & Medicaid Services (CMS) today honored a group of Medicare contractors for their excellent work on behalf of beneficiaries. These contractors respond to millions of queries from Medicare beneficiaries, their relatives, friends and caregivers concerning hospitals, doctors and other providers, and medical equipment and supplies. They provide high-quality health care, as well as timely and accurate information to Medicare beneficiaries.
The awards, for providing exemplary customer service to Medicare beneficiaries during 2002 and throughout the first quarter of this calendar year, were presented at CMS' 2003 National Customer Service Conference in Scottsdale, Ariz.
"The values exhibited by these contractors embody Medicare's commitment to our programs, as well as our pledge to quality services and responsiveness to beneficiaries, " CMS Administrator Tom Scully said. "We have worked together with our contractors to make sure Medicare is even more open and responsive to the needs and concerns of beneficiaries."
CMS also presented awards to Medicare managed care organizations in urban and rural settings in Rochester, N.Y., and La Crosse, Wis., respectively, and a Medicare Part B Medical Director in Indianapolis, Ind.
The contractor winners recognized for exemplary customer service are:
Medicare Part A contractor: Riverbend Government Benefits Administrator in Chattanooga, Tenn., covering New Jersey and Tennessee. For telephone customer service for beneficiaries about inpatient hospital care and other services.
Medicare Part B contractor: AdminaStar Federal in Indianapolis, Ind., covering Indiana and Kentucky. For telephone customer service responding to questions on Medicare Part B including physician services.
Durable Medical Equipment Regional Carriers (DMERCs): CIGNA Medicare in Nashville, Tenn., covering 18 states primarily in the West and Midwest, and American Samoa and the Northern Mariana Islands. For outstanding telephone customer service in meeting the health care information needs of Medicare's beneficiaries regarding medical equipment and supplies.
Regional Home Health Intermediary (RHHI): Palmetto Government Benefits Administrator in Columbia, S.C., covering 16 states. For exemplary customer service to Part B/RHHI Medicare beneficiaries during 2002 and 2003. The RHHI pays claims for home health services and checks on the quality of home health care.
Quality Improvement Organizations (QIOs): Rhode Island Quality Partners in Providence, R.I. The Rhode Island organization was honored for its leadership among QIOs, its partnership with national nursing home organizations and health care providers, and the production of technical materials and tools to help ensure the success of the Nursing Home Quality Initiative.
Rhode Island Quality Partners also has been recognized by other QIOs for its major contributions to creating an effective community of practice supporting the Nursing Home Quality Initiative, and for its liaison with many provider groups in helping that initiative to succeed.
Adrian Oleck, M.D., Medical Director for AdminaStar Federal in Indianapolis, received an award from CMS for his consistent, outstanding and dedicated service in ensuring that Medicare beneficiaries have access to the highest quality medical care. CMS said he consistently balances the needs of beneficiaries, providers and taxpayers in the work he does for Medicare.
Managed care organizations: CMS gave an award to a managed care organization in an urban setting to Preferred Care, Rochester, N.Y., and an award to a managed care organization in a rural setting to Gundersen Lutheran Health Plan, based in La Crosse, Wis. Both plans were selected for exemplary customer service to Medicare+Choice beneficiaries.
The approval rating for a managed care plan is derived from a question on the Consumer Assessment of Health Plan Satisfaction (CAHPS). This annual nationwide survey of Medicare beneficiaries enrolled in managed care organizations collects information about experiences with their health plans. The overall rating is the average of the responses by current plan members. CAHPS information about these plans is available at www.Medicare.gov/MPHCompare/Home.asp.
Currently, Medicare+Choice health maintenance organizations (HMOs) are available where private companies choose to offer them. About 4.6 million Medicare beneficiaries -- out of a total of about 40 million aged and disabled Americans -- have enrolled in Medicare HMOs. Original fee-for-service Medicare, available to all beneficiaries, is currently chosen by more than 35 million beneficiaries.