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Medicare Part D Payments for Service Dates After Individuals' Dates of Death

Under Medicare Part D, individuals entitled to Medicare benefits under Part A or enrolled in Part B and who live in the service area of a Part D plan may obtain prescription drug coverage. Centers for Medicare & Medicaid Services contracts with private prescription drug plans and Medicare Advantage plans (collectively known as sponsors) to offer prescription drug benefits to eligible individuals. A prior OIG review of deceased beneficiaries (OEI-04-12-00130) determined that Medicare improperly made $23 million in payments in 2011, of which $1 million was directly related to Medicare Part D payments that were made that year after beneficiaries' deaths. Centers for Medicare & Medicaid Services pays prescription drug plan organizations for Part D benefits prospectively. A Part D sponsor must disenroll a beneficiary from its prescription drug plan on the death of the individual, which is effective the first day of the calendar month following the month of death. We will determine whether prospective payments made after a beneficiaries' date of death were in accordance with Medicare requirements.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
Completed Centers for Medicare & Medicaid Services Medicare Part D Payments for Service Dates After Individuals' Dates of Death Office of Audit Services A-07-16-05088; W-00-17-35773 2018