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Medicare part D gives a certain dollar amount in benefits to each beneficiary per year. To receive more than that is crossing the line. I ain't saying I can blame them, but I wouldn't personally be "teaching" the lesson just to CYA.
No it doesn't. It pays private health insurance companies a certain amount of premium to offer approved coverages. If the previous carriers were required to report the utilization of the patients along with the prior enrollment information and the beneficiaries weren't reporting it then I'd be inclined to agree with you, but there is no mechanism for reporting the RX coverage usage even if a member wanted to tell them. CMS doesn't police this because it's a non-issue. CMS will pay the same to the carriers whether the beneficiaries receive the extra drug coverage or not, so why not inform beneficiaries of what they're entitled to? There is nothing dishonest, unethical, or questionable about this and any regulatory agency would find zero issue with it.