South Carolina Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs

Date Issued

Wednesday, August 10, 2022

Submitting OIG

Department of Health & Human Services OIG

Agencies Reviewed/Investigated

Department of Health & Human Services

Report Number

A-07-21-07003

Report Type

Audit

Agency Wide

Yes

Number of Recommendations

Questioned Costs

Funds for Better Use

Hide this report from display

Yes

Open Recommendations

This report has 5 open recommendations.

Recommendation Number	Significant Recommendation	Recommended Questioned Costs	Recommended Funds for Better Use
22-A-07-08001	No	$14,281,626	$0
Refund to the Federal Government $14,281,626 (Federal share) for claims for single-source physician-administered drugs that were ineligible for Federal reimbursement
22-A-07-08002	No	$241,533	$0
Refund to the Federal Government $241,533 (Federal share) for claims for top-20 multiple-source physician-administered drugs that were ineligible for Federal reimbursement
22-A-07-08003	No	$0	$0
Work with CMS to determine the unallowable portion of $1,328,195 (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
22-A-07-08004	No	$0	$0
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
22-A-07-08005	No	$0	$0
Continue to review and strengthen its internal controls to ensure that all physician-administered drugs eligible for rebates are invoiced