Indiana Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs
Indiana did not always comply with Federal Medicaid requirements for invoicing manufacturers for rebates for physician-administered drugs. Indiana did not invoice manufacturers for rebates associated with $710,420 (Federal share) in physician-administered drugs. Of this amount, $695,070 was for single-source drugs, and $15,350 was for top-20 multiple-source drugs. Because Indiana's internal controls did not always ensure that it invoiced manufacturers to secure rebates, Indiana improperly claimed Federal reimbursement for these single-source drugs and top-20 multiple-source drugs.
Further, Indiana did not submit the drug utilization data necessary to secure rebates for other physician-administered drugs totaling $142,339 (Federal share). Of this amount, $135,661 was for claims that did not have NDCs and $6,678 was for claims that contained NDCs.
We recommended that Indiana refund $710,420 and work with CMS to determine the proper resolution of the $142,339 for the other drug claims in question. We also made procedural recommendations. 
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Translation
Indiana partially agreed with our first three recommendations, agreed with our other two recommendations, and described corrective actions that it had taken or planned to take.
Filed under: Center for Medicare and Medicaid Services