Medicare Part D payments to skilled nursing facilities will face increased scrutiny over the next year from a federal watchdog agency.
The Department of Health and Human Services’ Office of Inspector General on Wednesday announced a slate of new audits underway for the agency, including a review of improper Medicare Part D payments related to SNF stays.
The OIG noted Medicare Part A payments to SNFs cover most services, including drugs used to care for and treat residents, and Part D drug plans should not be paying for prescription drugs related to post-hospital SNF care.
The investigation will focus on whether Medicare Part D paid for drugs that should have been paid under Part A SNF stays. Findings are expected to be completed by 2022. A 2019 OIG report found that Medicare Part D paid more than $160 million for drugs that were covered under Part A.
The OIG’s updated work plan also includes investigations into Medicare Part B telehealth services during COVID-19 and state compliance with the National Background Check Program for Long-Term Care Providers.
“We will determine whether Medicaid beneficiaries in nursing homes in selected states were adequately safeguarded from caregivers with a criminal history of abuse, neglect, exploitation, mistreatment of residents, or misappropriation of resident property, according to federal requirements,” the OIG wrote.