Former Alaska Gov. Sarah Palin (R) on Tuesday said that the forthcoming merged healthcare bill could contain the so-called "death panels" she first mentioned over the summer.

Palin took to Twitter, saying that the merged bill could be "unrecognizable" from the House and Senate bills:

...merged bill may b unrecognizable from what assumed was a done deal:R death panels back in?what's punishment 4not purchasing mandated HC?

The 2008 GOP vice presidential nominee added that opponents of the healthcare bill should "pay more attention" now that President Barack Obama is "threatening" to pass the overhaul:

NOW w/the Prez "threatening" &Congress "rushing" is when we MUST pay more attention than ever 2what this HealthCare Takeover is all about...

Palin's comments come as the Senate is moving closer toward voting to end debate on its version of healthcare reform legislation. Should the Senate pass its bill, negotiators from both chambers will merge the two bills that have several substantiative differences.

Several House Democrats have said they would push hard to include provisions from their bill in the final version despite the fact that the Senate is expected to hold the upper hand in negotiations.

In her first "death panel" charge, Palin wrote in a Facebook note that seniors "have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,'" under the healthcare legislation favored by President Barack Obama and congressional Democrats.

The former governor also repeated the allegation in November.

The charge has raised the ire of the bill's supporters, who said it was not true.

On Tuesday, the office of House Speaker Nancy Pelosi (D-Calif.) circulated a report that had selected the "death panel" charge as its "Lie of the Year."

Palin said on Twitter she would write a new Facebook note about healthcare reform shortly.

Cross-posted to the Twitter Room.