According to a recent OIG report, “Ensuring That Medicare Part D Reimbursement Is Limited to Drugs Provided for Medically Accepted Indications,” Medicare Prescription Drug Plan (PDP) sponsors do not have access to information necessary to ensure that Medicare Part D reimbursement is limited to drugs provided for medically-accepted indications (e.g., uses approved by Food and Drug Administration and supported by one or more of three specified compendia). For instance, three PDP sponsors included in the OIG review do not routinely collect diagnosis information except when using prior authorization, but CMS limits the use of prior authorization for antipsychotic drugs. All three PDP sponsors reported using postpayment review as a general safeguard to prevent fraud and abuse, but these reviews do not usually focus on medically-accepted indications. The OIG continues to recommend that CMS facilitate PDP sponsors’ access to information necessary to ensure appropriate reimbursement of Part D claims. In response to the OIG report, CMS notes a number of hurdles to implementing the OIG’s recommendation. For instance, CMS does not have the statutory authority to require physicians to include diagnosis information on prescriptions (and such diagnosis information may not provide sufficient granularity to determine appropriateness), while prior authorization can be costly and burdensome. CMS maintains that its current approach, permitting PDP sponsors to use prior authorization to target drugs that are at high risk for being prescribed without a medically accepted indication, is the appropriate balance.