In Medicare Part D, enrollees in stand-alone prescription drug plans (PDPs) are allowed to switch plans during an annual coordinated election period (AEP) set under law from November 15 to December 31, with new coverage effective January 1. The Centers for Medicare & Medicaid Services (CMS) required that plan sponsors send an Annual Notice of Change (ANOC)--using either its model or a nonmodel format--before the 2008 AEP. Among other things, GAO examined: (1) stakeholders' views of the model ANOC and CMS's efforts to assure its effectiveness, and (2) how the scheduling of the AEP affects the enrollment process for beneficiaries switching PDPs. Among the largest PDP sponsors, we selected eight to interview along with other stakeholders involved in the AEP. We also obtained and analyzed data from CMS.
Matter for Congressional Consideration
|To improve the Part D enrollment process, Congress may wish to consider authorizing the Secretary of HHS to amend the current AEP schedule to include a sufficient processing interval to fully enroll beneficiaries prior to the effective date of their new coverage.||The Patient Protection and Affordable Care Act amended the schedule for the Part D annual election period.|
Recommendations for Executive Action
|Centers for Medicare & Medicaid Services||To ensure that beneficiaries are informed effectively of plan changes, the Acting Administrator of CMS should strengthen the agency's evaluation of the Annual Notice of Change-Evidence of Coverage (ANOC-EOC) by reviewing alternative formats that include personalized drug coverage and cost information.|