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Medicare Part D paid more than $160 million for drugs in 2016 that should have been covered under the Part A hospice benefit, a government report found. 

That means the drugs were essentially paid for twice, the HHS Office of Inspector General’s report said in its review of Part D records for hospice care beneficiaries. 

Among the reasons for hospice errors: Hospice staff said they had no knowledge that the medication was prescribed by an outside physician, filled by an outside pharmacy, or both, or had no knowledge that the medication was ordered by nursing home staff and filled by an outside pharmacy.

CMS must “do more to avoid paying twice for the same drugs” and find a better strategy, the report said. Making sure that Part D doesn’t pay for drugs covered under Part A “would save at least an estimated $160.8 million a year in Part D total cost, with potentially much higher annual savings associated with the drugs that hospices said they were not responsible for providing,” the report states. 

CMS makes a per diem payment to providers for each day a beneficiary is in hospice care, regardless of the number of services provided, including medications.

In its response, CMS Administrator Seema Verma said the agency has previously worked to reduce duplicate payments and will “continue to take the OIG’s findings into account” as it works to solve the issue.

In a statement, the National Hospice and Palliative Care Organization agreed that providers “should be held responsible” for drugs related to terminal diagnosis and related conditions, but there may be instances where those medications should be billed separately to Medicare Part D. 

“The OIG report represents an opportunity to revisit Medicare Part D policy and further clarify billing and payment practices that will promote transparency and ensure that hospice patients receive the medications they need every day,” the statement said.