The OIG has issued a report entitled "Medicare Could Be Paying Twice for Prescription Drugs for Beneficiaries in Hospice.” Under the Medicare Part A hospice benefit, prescription drugs related to beneficiaries’ terminal illnesses are covered under the per diem payments made to hospice organizations, based on the level of care received by the individual beneficiary. The HHS Office of Inspector General (OIG) recently reported, however, that 198,543 hospice beneficiaries received 677,022 prescription drugs through the Medicare Part D program in 2009 that potentially should have been covered by hospice per diem payments because the particular drugs (analgesics, antinauseants, laxatives, and antianxiety drugs) primarily are used for palliative care. Part D plans paid pharmacies more than $33.6 million for these drugs, and beneficiaries paid $3.8 million in copayments. OIG also stated that there could be duplicate billing for prescription drugs that are commonly used to treat two terminal diagnoses: chronic obstructive pulmonary disease (COPD) and amyotrophic lateral sclerosis (ALS). To prevent Medicare from paying for the same prescription drugs under both Part A and Part D, the OIG recommends that CMS expand education efforts about drug coverage for hospice beneficiaries, perform oversight activities to ensure that Part D is not paying for drugs that Medicare has already covered under hospice per diem payments, and require Part D plan sponsors to develop controls preventing Medicare Part D from paying for drugs covered under the hospice benefit. Note that the OIG’s report is not entirely clear on whether Part D was billed for the drugs because the hospices concluded that these medications were not related to beneficiaries’ terminal illnesses, or through an error. Further, CMS disputed one of the OIG’s recommendations, arguing that OIG had not proven that duplicate payments in fact were made.