|Articles|October 31, 2014

Medicare Budget Pinched By Payments for the Departed

An investigation into 2012 Medicare claims for HIV-infected patients unearthed payment for prescriptions that were filled up to 32 days after the patient's passing.

Call it drugs for the departed: Medicare's prescription program kept paying for costly medications even after patients were dead.

The problem was traced back to a head-scratching bureaucratic rule that's now getting a second look.

A report coming out Friday from the Health and Human Services Department's inspector general says the Medicare rule allows payment for prescriptions filled up to 32 days after a patient's death — at odds with the program's basic principles, not to mention common sense.

"Drugs for deceased beneficiaries are clearly not medically indicated, which is a requirement for (Medicare) coverage," the IG report said. It urged immediate changes to eliminate or restrict the payment policy. Medicare said it's working on a fix.

Investigators examined claims from 2012 for a tiny sliver of Medicare drugs — medications to treat HIV, the virus that causes AIDS — and then cross-referenced them with death records. They found that the program paid for drugs for 158 beneficiaries after they were already dead. The cost to taxpayers: $292,381, an average of $1,850 for each beneficiary.

Medicare's "current practices allowed most of these payments to occur," the report said.

Complete report on abcNews: http://abcn.ws/1u0NPUN

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