Government Watch

Your Tax Dollars At Work: Feds Spent $29 Million on Prescription Drugs for 4,139 Illegal Aliens

( –  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.

Each time a Medicare Part D beneficiary fills a prescription, his or her plan sponsor is required to fill out a PDE and submit it to CMS. Medicare Part D providers receive “prospective payments…based on information in the sponsors’ approved annual bids” which are later reconciled with actual prescription costs.

CMS uses data from the Social Security Administration to determine Medicare eligibility, but “CMS did not have a policy addressing payments for unlawfully present beneficiaries under Medicare Part D that was equivalent to the existing policy that covers payments for these beneficiaries under Parts A and B,” the IG reported.

“Because CMS did not have such a policy, it did not have internal controls to identify and disenroll unlawfully present beneficiaries and to automatically reject PDE records associated with them,” auditors noted.

The IG recommended that CMS “develop and implement controls to ensure that Medicare does not pay for prescription drugs for unlawfully present beneficiaries” by preventing them from enrolling, disenrolling those already in the Medicare Part D system, and “automatically rejecting PDE records submitted by sponsors for prescription drugs provided to this population.”

The IG also recommended that CMS take steps to recover the $29 million. However, CMS said that “there was no effective way to fully recover the improper payments in question without first implementing the appropriate policies and procedures” that would have prevented the overpayment problem in the first place.

If You Enjoy Articles Like This - Subscribe to the AMAC Daily Newsletter
and Download the AMAC News App

Sign Up Today Download

If You Enjoy Articles Like This - Subscribe to the AMAC Daily Newsletter!

Notify of
Oldest Most Voted
Inline Feedbacks
View all comments
8 years ago

Thank you for another informative site. The place else may I am getting that kind of information written in such a perfect manner? I have a challenge that I’m simply now operating on, and I have been at the look out for such info.

8 years ago

Obama & the Democrats want illegals here & are giving them free stuff to buy their votes when they do become legal. Just wait, the Democrats will put an excellerated “path to citizenship” in their immigration bill they will try to force through or Obama will issue an Executive Order. Democrats are working to make Texas another California & New York, turning it into a Democrat state. I hope Gov Perry & the Republican Party are working to prevent this but the plan has already been in affect for some time.

8 years ago

I find all this both fascinating and incredibly sad. As other countries around the world are waking up to the high costs associated with treating illegals in their own countries and thus tightening their rules to exclude non-citizens from getting health care and prescription drugs on their own taxpayers’ dime, we are either ignoring the problem or actively seeking to expand the number of illegals getting access to both here. Washington continues to refuse to learn from the mistakes of other countries, that they themselves are now trying to correct to avoid national bankruptcy.

8 years ago

How about the government spending 29 million $$ to round up the 30-40 million illegal, err, undocumented immigrants and enforce our current existing immigration law otherwise, why should any of us obey any laws??? Isn’t it amazing Congress wants to address this issue, but, has to change all our health insurance coverage instead of just addressing the problems of the small minority of uninsured people? Just common sense to most of us, but, oh yeah, liberals don’t have any common sense, otherwise, they wouldn’t be liberals … Duh!!!

8 years ago

The foreigner residing among you must be treated as your native-born. Love them as yourself, for you were foreigners in Egypt. I am the LORD your God. Lev. 19:34

8 years ago
Reply to  Leone

Sorry, but that doesn’t mean we should be paying for the prescription drugs of people that are in this country illegally. If you were in a foreign country illegally, I would guarantee you that you would be expected to pay for whatever prescription drugs you required. For that matter, you would likely find yourself arrested and facing either prison or deportation for being in the country illegally. We are a compassionate nation, but we should not behave as fools or as door mats to the rest of the world.

8 years ago

Why aren’t our Seniors who are struggling getting these benefits? There is something definetly wrong with our government.

8 years ago

Obamacare provides healthcare for illegal aliens. So, nothing will be done about this. Illegals have better benefits of all types than USA citizens and there are so many of them (illegals). It’s scary and sad to think of how poor our country is becoming and the speed at which it is falling.

8 years ago

Were there no policies & procedures covering this prior to 2009? If so, why were there none during this time frame? OR, has this just become an issue since the current administration took over?

8 years ago

Just what I wanted to read after having to pay for my prescriptions at walgreens today after paying my dentist cash! This SUCKS

Would love your thoughts, please comment.x