Barbara Hollingsworth
CNS News
November 5, 2013
The Centers for Medicare and Medicaid Services (CMS) spent almost $29 million to cover Medicare Part D prescription drugs for 4,139 individuals “unlawfully present” in the U.S. and thus ineligible to receive federal health care benefits, according to an audit by Daniel Levinson, inspector general of the Department of Health & Human Services. (See Medicare prescription drugs.pdf)
CMS “inappropriately accepted 279,056 PDE [prescription drug event] records with unallowable gross drug costs totaling $28,990,718” between 2009 and 2011, Levinson reported. Total federal expenditures under Medicare Part D during that same two-year time period came to $227 billion.
Medicare Parts A and B cover hospitalization, skilled nursing care, doctor visits, and other medical services and supplies. The IG previously reported in January that CMS had also paid $91.6 million to health care providers to cover 2,600 ineligible illegal aliens.
The unallowable payments were made by CMS despite the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, which prohibits illegal aliens from receiving federal health care benefits, and CMS’ own 2003 memo warning: “Make no payments for Medicare services furnished to an alien beneficiary who is not lawfully present in the United States.”
Medicare Part D is a voluntary program that requires individuals who are entitled to benefits under Part A or enrolled in Part B to opt in by filling out a form to enroll in a federally approved prescription drug plan that has a contract with CMS. Enrollee premiums cover about a quarter of the overall cost, with Medicare picking up the rest.
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