When Nevada billed manufacturers for rebates for physician-administered and pharmacy drugs, it did so correctly. However, Nevada estimated that it did not bill for rebates of $520,137 ($327,624 Federal share) for physician-administered and pharmacy drugs that were eligible for rebates. In addition, Nevada did not bill for rebates for 19,650 claim lines for other physician-administered and pharmacy drugs that may have been eligible for rebates. Because there was insufficient information to determine the amount of any rebates that may have been due, we set aside these claim lines for resolution by the Centers for Medicare & Medicaid Services (CMS). Nevada's internal controls did not ensure that it billed for and collected rebates for all drugs dispensed to enrollees of Medicaid managed-care organizations (MCOs).
NV
United States
