Federal Reports

Manufacturer rebates for drugs paid through Medicaid managed care organizations (MCOs) are an increasingly important source of savings for both States and the Federal government. However, "duplicate discounts," which occur when manufacturers pay Medicaid rebates on drugs sold at the already discounted 340B price, are prohibited by law. Thus, for States to collect allowable rebates only and avoid duplicate discounts for drugs paid through MCOs, they must identify and exclude 340B drug claims. If a State does not accurately identify 340B drug claims, both duplicate discounts and forgone rebates-that is, unclaimed rebates to which States are legally entitled-may occur. Duplicate discounts result in manufacturers paying too much in rebates, while forgone rebates result in States paying too much for drugs.

OIG administers the Medicaid Fraud Control Unit (MFCU or Unit) grant awards, annually recertifies the Units, and oversees the Units' performance in accordance with the requirements of the grant. As part of this oversight, OIG conducts periodic reviews of all Units and prepares public reports based on these reviews. These reviews assess Units' adherence to the 12 MFCU performance standards and its compliance with applicable Federal statutes and regulations.

This report provides a summary of our investigative findings in cases involving administrative misconduct.