Free Republic

Under the rules that took effect in May, hospice patients or their families could not fill prescriptions through their Part D drug plans until first confirming that the prescriptions were not covered by hospice providers. Drugs related to palliative and comfort care are supposed to be covered under the fixed rate payments to the hospice. Medicare announced Friday that the rules would be revised so that the additional authorization would be required for only four types of medications: pain relievers, anti-nauseants, laxatives, and anti-anxiety drugs that are “nearly always” considered hospice-related.

The Obama administration on Friday backed down on restrictions of private insurance coverage for hospice drugs under Medicare, saying the regulations were preventing some terminally ill patients from having access to medicine. Under Medicare's Part A hospital program, hospices receive daily payments for each patient but are responsible for all drugs related to a patient's terminal illness. Medicare Part D covers only prescriptions and medications for curative conditions that are unrelated to a terminal illness.

With just a handful of prescriptions to his name, psychiatrist Ernest Bagner III was barely a blip in Medicare’s vast drug program in 2009. But the next year he began churning them out at a furious rate. Not just the psych drugs expected in his specialty, but expensive pills for asthma and high cholesterol, heartburn and blood clots. By the end of 2010, Medicare had paid $3.8 million for Bagner’s drugs 2014 one of the highest tallies in the country. His prescriptions cost the program another $2.6 million the following year, records analyzed by ProPublica show. Bagner, 46, says there’s...