Medicare's Part D drug benefit has a strange rule that allows a person's prescription to be filled up to 32 days after he or she has died, according to a report released today (on Halloween) by the Health and Human Services Department inspector general. Under that loophole, Medicare paid for HIV drugs for 158 beneficiaries in 2012 alone, at a cost of $292,381.
"Drugs for deceased beneficiaries are clearly not medically indicated, which is a requirement for (Medicare) coverage," says the report. Medicare agrees, promising to rework the rule with the private insurers that provide the drug benefit under Part D. The report looked only at HIV medications, which are among the most expensive drugs (and thus more at risk of being diverted to the black market), but the costs could add up quickly if other, cheaper drugs are similarly paid for during the month after a beneficiary's death.
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