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Medicare: Callers Can Access 1-800-MEDICARE Services, but Responsibility within CMS for Limited English Proficiency Plan Unclear

GAO-09-104 Published: Dec 29, 2008. Publicly Released: Jan 28, 2009.
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Highlights

The Centers for Medicare & Medicaid Services (CMS) is responsible for providing beneficiaries timely and accurate information about Medicare. Receiving nearly 30 million calls in 2007, 1-800-MEDICARE, operated by a contractor, is the most common way members of the public get program information. The help line provides services both to English-speaking and limited English proficiency (LEP) callers. In this report, GAO describes (1) the extent to which access performance standards and targets have been met by the current contractor, (2) the efforts by CMS to provide LEP callers access to help line services and wait times experienced by these callers, and (3) CMS's oversight of callers' access to 1-800-MEDICARE and the information's accuracy. To conduct this work, GAO reviewed documents and analyzed help line data through July 2008. In addition, GAO interviewed agency staff, industry experts, and officials at four federal agencies with high call volume contact centers.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Centers for Medicare & Medicaid Services To ensure CMS offices, including those that oversee the operation of the 1-800-MEDICARE help line are aware of, and take steps consistent with, the Department of Health and Human Services (HHS) LEP Plan when considering the needs of people with LEP, CMS should designate an official or office with responsibility for managing the LEP Plan.
Closed – Implemented
In response to our recommendation, an official within the CMS Office of Equal Opportunity and Civil Rights was designated as the lead for CMS' Strategic Language Access Plan, which was implemented Nov. 30, 2010. The official (the Civil Rights Agency Liaison) is tasked with various responsibilities under the plan, including sharing data within CMS on estimated language needs of CMS customers and establishing a work group to develop a Language Access Assessment report with recommendations for improvement and documented "proven practices." By designating a responsible official, an internal control for federal agencies, CMS has provided staff with a source of guidance to assist them in taking steps consistent with the Limited English Proficiency (LEP) Plan when considering the needs of people with LEP. Specifically, this official can help to provide guidance in areas where steps consistent with the LEP Plan have not been taken and can work to ensure consistent use of the Plan across the agency.

Full Report

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Topics

BeneficiariesContract performanceContractorsCustomer serviceFee-for-service plansForeign languagesHealth care servicesInformation accessInformation centersInformation disclosureInternal controlsMedical equipmentMedical information systemsMedicarePerformance measuresProgram evaluationProgram managementPublic healthStandards evaluationStrategic planningSurveysNon English speakingTranslating and interpreting