Insurance Commissioner Donelon announces the first pilot program of its type in the nation between the Louisiana Department of Insurance (LDI) Senior Health Insurance Information Program (SHIIP) and the Center for Medicare & Medicaid Services (CMS). Based on our excellent working relationship, the Dallas Regional Office of CMS has asked the LDI SHIIP to participate in a new pilot project that will test the feasibility of having the SHIIP directly enter its Medicare Advantage (Part C) and Prescription Drug (Part D) complaints into the CMS Complaints Tracking Module (CTM). The CTM is the central repository of complaints received primarily through the 1-800-MEDICARE call centers.

“Accolades go to LDI SHIIP Director Vicki Dufrene and her staff for their exemplary work with CMS, which is why Louisiana’s SHIIP was the first state to be chosen for this pilot program. Since the LDI SHIIP staff will be entering the consumer complaints directly into the CTM, we will be better able to track the status of the complaint until resolution and have more interaction with the consumer who filed the complaint,” said Commissioner Donelon regarding the pilot program. “LDI SHIIP staff will have more control with the issues of the insured.”

Under the pilot:

• LDI SHIIP will have the ability to enter complaints directly into the CTM to avoid the wait times at
1-800-MEDICARE.

• Direct access for the LDI SHIIP will provide the opportunity to send issues directly to plans real-time.
Complaints referred to plans through 1-800-MEDICARE are currently not viewable by the plans until the next
business day.

• Upon receiving complaints, plans will have the same obligation to act quickly and meet CMS expectations
with respect to casework resolution.

• LDI SHIIP will be able to directly review actions that plans have taken, instead of contacting the CMS Regional
Office or the plan for status.

• LDI SHIIP involvement frees up resources at the CMS Regional Office, which can then be devoted to pressing
Congressional inquiries and other casework issues that are delegated exclusively to the Regional Office for
handling.

Louisiana is the first state to implement the pilot program and based on Louisiana’s input, an additional eight States will be brought into the pilot program within two to four weeks. After four to six months, CMS and senior programs of other states will evaluate the pilot program and determine whether to continue adding additional states.