Medicare might have made duplicate payments for medications used by hospice beneficiaries, OIG report suggests
Medicare might have made duplicate payments for medications used by hospice beneficiaries, OIG repor
Medicare Part D, the Medicare program's prescription drug benefit, paid for medications used in hospice settings — treatments that are already covered by per diem payments by Medicare Part A. Medicare Part A is the program that pays for hospice care. These payments were identified in an investigation by the Department of Health and Human Services Office of the Inspector General.
According to the report, “198,543 hospice beneficiaries received 677,022 prescription drugs through the Medicare Part D program that potentially should have been covered under the per diem payments made to hospice organizations. Part D paid pharmacies $33,638,137 for these prescription drugs, and beneficiaries paid $3,835,557 in copayments.”
The OIG recommended that the Centers for Medicare & Medicaid Services: conduct additional education efforts to hospices and pharmacies about Medicare Part D's role in paying for end-of-life care; perform more oversight operations; require sponsors to develop controls that prevent Part D from paying for drugs that are already covered under the per diem payments.
Click here to read the full OIG report.