NCPA - National Center for Policy Analysis

Medicare Paying for Drugs for the Dead

November 11, 2014

The Inspector General within the Department of Health and Human Services has released a new report revealing a bizarre rule within the Medicare program: it covers payment for prescription drugs filled up to a month after a patient has died.

As a result, Richard Alonso-Zaldivar at PBS News explains, Medicare has paid for drugs for the dead:

  • Analyzing HIV and AIDS drugs dispensed in 2012, the agency compared drug claims with death records, finding that the program paid for drugs for 158 dead beneficiaries.
  • Taxpayers paid $292,381 for these drugs, or $1,850 per beneficiary.
  • A total of 348 prescriptions for these illnesses were dispensed. Of those, half were filled over a week after the patient's death.

Where did the drugs go? According to Alonso-Zaldivar, they could have been diverted to the black market. He notes that HIV drugs are incredibly expensive, with a common drug costing $1,700 each month. Indeed, in a recent study, NCPA Senior Fellow Devon Herrick wrote about drug fraud within the Medicare program, noting the potential of expensive drugs like HIV medication to be diverted to the illicit market. Drug fraud, especially for painkillers, is a problem within Medicare. He urged Medicare Part D to allow for a "lock-in" program, which would allow drug plans to restrict patients' ability to access certain classes of drugs from more than one doctor or one pharmacy.

Source: Richard Alonso-Zaldivar, "Medicare paid for drugs after patients had died, report finds," PBS Newshour, October 31, 2014. 


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