With certain exceptions, self-administered drugs are typically not covered under Medicare Part B. However, in a November 2017 report, OIG found that CMS and a Federal court interpret relevant statute to require the inclusion of versions of drugs not generally covered under Part B in limited circumstances when setting Medicare payment amounts. As a result, CMS included noncovered, self-administered versions of Orencia and Cimzia when determining payments for those two drugs. The inclusion of these noncovered versions caused Medicare and its beneficiaries to pay an extra $366 million from 2014 through 2016. OIG recommended that CMS seek a legislative change that would provide the agency with flexibility to determine when noncovered versions of a drug should be included in the calculation of the Part B payment amount. CMS did not concur with our recommendation and, to date, no action has been taken to close the payment loophole.
| Report Date | Agency Reviewed / Investigated | Report Title | Type | Location | |
|---|---|---|---|---|---|
| Department of Health & Human Services | Loophole in Drug Payment Rule Continues To Cost Medicare and Beneficiaries Hundreds of Millions of Dollars | Inspection / Evaluation | Agency-Wide | View Report | |
| Department of Energy | The Department of Energy’s Federal Employee Substance Abuse Testing Program | Audit |
|
View Report | |
| Department of Justice | Interim Report - Review of the Office of Justice Programs’ Administration of CARES Act Funding | Other | Agency-Wide | View Report | |
| Tennessee Valley Authority | Grid Access Charge | Inspection / Evaluation | Agency-Wide | View Report | |
| Internal Revenue Service | Tax Compliance Checks for Federal Employment Suitability Have Improved, but There Are Still Some Inconsistencies | Audit | Agency-Wide | View Report | |
| Internal Revenue Service | The Annual Inventory Certification Process for Non–Information Technology Assets Needs Improvement | Audit | Agency-Wide | View Report | |
| Department of Defense | Audit of Purchases of Ammonium Perchlorate Through Subcontracts With a Single Department of Defense-Approved Domestic Supplier | Audit | Agency-Wide | View Report | |
| Department of State’s Humanitarian Mine Action, Conventional Weapons Destruction, and Technical Assistance in Afghanistan: Audit of Costs Incurred by Janus Global Operations LLC | Other | Agency-Wide | View Report | ||
| Department of Justice | Audit of the Office of Justice Programs Victim Assistance Grants Awarded to the New Jersey Department of Law and Public Safety, Trenton, New Jersey | Audit |
|
View Report | |
| Department of Health & Human Services | Texas Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities | Audit |
|
View Report | |
