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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
Components
Centers for Medicare and Medicaid Services
Report Number
A-07-21-07002
Report Type
Audit
Number of Recommendations
3
Questioned Costs
$3,585,422
Funds for Better Use
$0
External Entity
North Carolina Department of Health and Human Serv

Open Recommendations

This report has 3 open recommendations.
Recommendation Number Significant Recommendation Recommended Questioned Costs Recommended Funds for Better Use Additional Details
23-A-07-040.03 No $684,731 $0

We recommend that the North Carolina Department of Health and Human Services, Division of Health Benefits work with CMS to determine the unallowable portion of $684,731 (Federal share) for other claims for multiple-source physician-administered drugs that may have been ineligible for Federal reimbursement, refund that amount, and consider invoicing drug manufacturers for rebates for these drugs if CMS determines that the drug claims are allowable.

23-A-07-040.04 No $0 $0

We recommend that the North Carolina Department of Health and Human Services, Division of Health Benefits work with CMS to determine and refund the unallowable portion of Federal reimbursement for physician-administered drugs that were not invoiced for rebates after December 31, 2019.

23-A-07-040.05 No $0 $0

We recommend that the North Carolina Department of Health and Human Services, Division of Health Benefits to strengthen its internal controls to ensure that all physician-administered drugs eligible for rebates are invoiced.

Department of Health & Human Services OIG

United States