A report released 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.
Of 348 prescriptions dispensed for the dead beneficiaries, nearly half were filled more than a week after the patient died. Sometimes multiple prescriptions were filled on behalf of a single dead person.
Investigators said they stumbled on the problem during an examination of coverage for AIDS drugs dispensed to Medicare beneficiaries. Sexually transmitted diseases are an increasingly recognized problem among older people.
That earlier investigation raised questions about expensive medications billed on behalf of nearly 1,600 Medicare recipients.
Some had no HIV diagnosis in their records, but they were prescribed the drugs anyway. Others were receiving excessively large supplies of medications. Several were getting prescriptions filled from an unusually large number of pharmacies.
