PUBLIC SUBMISSION | As of: June 22, 2010 Received: May 26, 2010 Status: Deferred Category: Health Plan or Association - HP010 Tracking No. 80af49b7 Comments Due: June 18, 2010 Submission Type: Web |
Docket: CMS-2010-0180
Medicare Advantage and Medicare Fee-For-Service Consumer Assessment of Healthcare Providers and Systems Survey (CAHPS) - CMS-R-246
Comment On: CMS-2010-0180-0001
Medicare Advantage and Medicare Fee-For-Service Consumer Assessment of Healthcare Providers and Systems Survey (CAHPS) - CMS-R-246
Document: CMS-2010-0180-DRAFT-0009
FL
Jacksonville, FL, 32246
Organization: Blue Cross & Blue Shield of FloridaCMS-R-246 - Proposed Revisions to CAHPS Survey
Our organization would like to submit the following comments:
Question 31 & 32:
31. Was there ever a time when you believed that you needed and should have received healthcare or services that your doctor decided not to give you?
32. Before today, did you know that you can ask (Health Plan) to reconsider your doctor’s decision not to provide health care or services.
Comment : Question 32 leads the member to think that the plan has a right to interfere with the physician's clinical decisions or plan of treatment. We propose that questions 31 and 32 be eliminated entirely. They would potentially promote unnecessary and potentially dangerous care for patients. An obvious example would be the provider appropriately refusing to prescribe antibiotics for a viral URI. The much bigger problem here is the overutilization of unnecessary care.
Question 48:
48. How long did it take to (insert plan name here) to resolve your complaint? (Same day, 1 week, 2 weeks, 3 weeks, 4 weeks, I am still waiting for it to be settled)
Comment:
1. How does this align with the CMS requirement that the plan has 30 days to respond to complaints?
2. We feel that the wording is confusing in regards to the responses. What happens if a member just submitted a complaint a few days before…then they would answer “I am still waiting for it to be settled.” Perhaps the response should say “I am still waiting for it to be settled, but it has been less/more than 30 days.”
Thank you for the opportunity to submit these comments.