Medicare Keeps On Paying for Drugs…After Death?

I recently read an HHS Inspector General report about Medicare paying for HIV  drugs … for the dead….The OIG report, Medicare Paid for HIV Drugs for Deceased Beneficiaries, released on Halloween (shades of trick or treat), is available here as a pdf.

OIG report # OEI-02-11-00172 focuses on HIV drugs and the prompt for the investigation was “ongoing concerns about Medicare paying for drugs and services after a beneficiary has died.”

The report found  that under the existing policy (which allows this to occur), Medicare continued to pay for HIV drugs for 150 decedents.  Medicare cuts off payments “for drugs with dates of service more than 32 days after death [because] CMS’s practices allow payment for drugs that do not meet Medicare Part D coverage requirements. Most of these drugs were dispensed by retail pharmacies.”

Why just look at HIV drugs because isn’t it likely that this continued payment could be occurring beyond just this group of drugs?  CMS agrees that “these “findings have implications for all drugs because Medicare processes PDE records for all drugs the same way. Considering the enormous number of Part D drugs, a change in practice would affect all Part D drugs and could result in significant cost savings for the program and for taxpayers.”

The OIG report recommends a change in practice to “prevent inappropriate payments for drugs for deceased beneficiaries  and lead to cost savings for the program and for taxpayers. CMS concurred with [the OIG] recommendation.”