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Medicare Part D Payments During Covered Part A SNF Stay

Medicare Part A prospective payments to skilled nursing facilities (SNFs) cover most services, including drugs and biologicals furnished by the SNF for use in the facility for the care and treatment of beneficiaries. Accordingly, Medicare Part D drug plans should not pay for prescription drugs related to posthospital SNF care because these drugs are already included in the consolidated payment for Part A SNF stays. We will determine whether Medicare Part D paid for drugs that should have been paid under Part A SNF stays.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
January 2021 Centers for Medicare and Medicaid Services Medicare Part D Payments During Covered Part A SNF Stay Office of Audit Services W-00-21-35866 2022