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Brought to you by the Council of the Inspectors General on Integrity and Efficiency
Federal Reports
Report Date
Agency Reviewed / Investigated
Report Title
Type
Location
Department of Health & Human Services
California Did Not Bill Manufacturers for Rebates for Physician-Administered Drugs Dispensed to Enrollees of Some Medicaid Managed-Care Organizations
From April 1 through December 31, 2010, 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 dispensed to enrollees of Medicaid managed-care organizations (MCOs). For the 20 MCOs we reviewed, the State agency billed for rebates for physician-administered drugs dispensed by 7 MCOs. However, the State agency did not bill for rebates for physician-administered drugs dispensed by the remaining 13 MCOs.
This report identifies management and performance challenges facing the Corporation. We selected these challenges considering past and ongoing audit, review, and investigative work, as well as discussions with CNCS management regarding existing vulnerabilities. We also considered new activities that could pose challenges because of their breadth and complexity.
