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Medicare Could be Paying Twice For…

Medicare Could be Paying Twice For…

In a report released by the Office of Inspector General (OIG) on June 28, 2012, the OIG concluded that the Medicare program could be paying twice for prescription drugs for hospice beneficiaries: once under the Medicare Part A hospice per diem payment and again under Medicare Part D. Additionally, hospice beneficiaries could be unnecessarily paying copayments for prescription drugs under Part D. CMS commented that the four categories of drugs analyzed by OIG are used for the treatment of hospice patients’ symptoms, as well as they may also be prescribed for uses unrelated to the terminal illness. While conceding that determining whether drugs are a hospice covered benefit can be clinically complex, OIG recommends that the issue warrants CMS’s increased attention.

CareRx has seen both extremes of including or excluding drugs as a hospice covered benefit. A CareRx clinical pharmacist can assist a hospice team in making appropriate determinations supported by clinical findings, and reduce the hospice risk exposure.

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