California Claimed Unallowable Federal Medicaid Reimbursement by Not Billing Manufacturers for Rebates for Some Physician-Administered Drugs 

The California Department of Health Care Services (State agency) did not always comply with Federal Medicaid requirements for billing manufacturers for rebates for physician-administered drugs during three selected quarters between 2008 and 2010. Of $178.6 million in claims that were billed for rebates, we reviewed $61.4 million associated with 26 National Drug Codes (NDCs) and 21 manufacturers to verify that the claims were properly billed for rebates. The entire amount was properly billed for rebates. However, the State agency did not bill for rebates for claims for physician-administered drugs totaling $58.9 million.