Home Health & Hospice Week

Inaccurate bids driving up patients' premiums, report finds. Part D sponsors owe Medicare million of dollars less for 2007 payment reconciliation than for 2006, but what they do owe is still too much. The HHS Office of Inspector General analyzed Part D reconciliations for both years and found that Part D sponsors only owed $18 million to Medicare for 2007 -- a huge decrease over the year before. Yet, "sponsors continue to submit inaccurate bids and make large unexpected profits," the OIG noted. Problem: Many sponsors overestimated the costs of providing the drug benefit -- leading to higher than necessary premiums for beneficiaries and larger than necessary payments from Medicare. But while Medicare can recoup its payments, beneficiaries can't. These mistakes also triggered Medicare's risk-sharing requirements. "Based on our calculations, the 179 sponsors that had profits large enough to trigger risk sharing made at least $1.02 billion in unexpected profits in 2007," [...]