Medicare Prescription Drug Benefit (Part D) Department of Health and Human Services

Medicare Prescription Drug Benefit (Medicare Part D) is a federal prescription drug benefit program for Medicare beneficiaries.

Agency Accountable Official: Jen Moughalian, Acting Assistant Secretary for Financial Resources

Program Accountable Official(s): Kimberly Brandt, Principal Deputy Administrator for Operations, Centers for Medicare & Medicaid Services

Total Payments
Improper Payments
Improper Payment Rate

Supplemental Measures

Current Measure: 2.39%

Target: 1.00%

Description: The Prescription Drug Event (PDE) validation process validates the prescription against the PDE data submitted to HHS for payment and is the major driver of error in Part D. The root cause shown under this annual supplemental measure is missing or illegible supporting documentation. The FY 2017 Part D supplemental measure is based on calendar year 2014 payments.

Update Frequency: Annually

Data Current as of: November 2017

Program Comments

In Fiscal Year (FY) 2017, HHS reported an error estimate for the Medicare Prescription Drug Program (Part D), based on Calendar Year 2015 payments.  The Part D improper payment estimate measures the payment error related to prescription drug event (PDE) data, where the majority of error for the program exists.

HHS measures the inconsistencies between the information reported on PDEs and the supporting documentation submitted by Part D sponsors: prescription record hardcopies (or medication orders, as appropriate), and detailed claims information.  Based on these reviews, each PDE in the audit sample is assigned a gross drug cost error, which is simulated onto a representative sample of beneficiaries to determine the Part D improper payment estimate. More information on this program can be found in the Department's Agency Financial Report (available at