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Date Issued
Submitting OIG
Department of Health & Human Services OIG
Other Participating OIGs
Department of Health & Human Services OIG
Agencies Reviewed/Investigated
Department of Health & Human Services
Report Number
A-05-17-00018
Report Description

For a covered outpatient drug to be eligible for Federal reimbursement under the Medicaid program's drug rebate requirements, manufacturers must pay rebates to the States for the drugs. Previous OIG audits found that States did not always bill and collect all rebates due for drugs administered by physicians to enrollees of Medicaid managed-care organizations (MCOs).Our objective was to determine whether Minnesota complied with Federal Medicaid requirements for billing manufacturers for rebates for drugs dispensed to MCO enrollees.

Report Type
Audit
Location

MN,
United States

Number of Recommendations
4
Questioned Costs
$5,899,308
Funds for Better Use
$0
External Link
https://go.usa.gov/x7WVa

Open Recommendations

This report has 4 open recommendations.
Recommendation Number Significant Recommendation Recommended Questioned Costs Recommended Funds for Better Use Additional Details
269607 No $5,899,308 $0

We recommend that the Minnesota Department of Human Services bill for and collect manufacturers’ rebates for pharmacy drugs and for single-source and top-20 multiple-source physician-administered drugs that we calculated to be $5,899,308 (Federal share) and refund the Federal Government

269608 No $0 $0

We recommend that the Minnesota Department of Human Services work with CMS to determine whether the non-top-20 multiple-source physician-administered drugs were eligible for rebates that we calculated to be at least $173,780 (Federal share) and, if so, upon receipt of the rebates, refund the Federal share of the rebates collected

269609 No $0 $0

We recommend that the Minnesota Department of Human Services work with CMS to ensure that all pharmacy and physician-administered drugs eligible for rebates after our audit period are processed for rebates

269610 No $0 $0

We recommend that the Minnesota Department of Human Services work with the contractor to confirm that DRAMS is properly identifying drug rebate eligibility to ensure that all rebate-eligible pharmacy and physician-administered drugs are identified and billed for rebates.

Department of Health & Human Services OIG

United States