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As if Medicare Part D isn't confusing enough, now there's some evidence that the Centers for Medicare and Medicaid Services (CMS) hasn't been checking up on the private health insurance agencies who are supposed to be administering the plan.

Medicare Part D is the prescription drug plan that was added to Medicare in 2006. It was designed to help older Americans pay for the rising costs of prescription medications, many of which are life-saving in nature, and can be highly expensive.

According to the article at MSN Health, a report released just this week finds that CMS hasn't audited private health insurance companies to make sure that Medicare Part D is being implemented along federal guidelines.

The result means the potential for tremendous amounts of fraud, taxpayer money lost, and perhaps millions of Americans who could be taken advantage of by less scrupulous insurance agencies.

This is yet another reason why it's so important to have all of your part D paperwork in writing, signed and set aside in case you discover that you haven't been dealt with properly. CMS has argued that congressional caps on their spending has made it too expensive to monitor these insurance companies.

But we have to ask: too expensive for whom?