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Department of Health and Human Services

Office of Inspector General -- AUDIT

"Follow-Up Audit of the Medicaid Drug Rebate Program In Wyoming," (A-07-08-03106)

May 27, 2008

PDF File Complete Text of Report is available in PDF format (2.32 mb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


In a follow-up audit of Wyoming’s Medicaid drug rebate program, we found that the State had implemented the recommendations from our prior audit relating to the maintenance of an adequate subsidiary accounts receivable system and had developed policies and procedures for the tracking, billing and accounting for $0 unit rebate amounts.  Manufacturers may make their outpatient drugs eligible for Federal Medicaid funding by entering into a rebate agreement with the Centers for Medicare & Medicaid Services (CMS) and paying quarterly rebates to the States.

However, the State continued to inaccurately report drug rebate activity on the Form CMS-64.9R.  Additionally, the State did not implement recommendations related to various accounting and dispute resolution procedures.  Finally, the State did not establish controls over and accountability for collecting rebates on single-source drugs administered by physicians.

We recommended that the State work with its contractor and CMS to determine how to correct the inaccuracies that were reported on the Form CMS-64.9R.  We also continued to recommend that the State improve its accounting and dispute resolution procedures and develop a system for the collection of drug rebates on single-source drugs administered by physicians.

In written comments on our draft report, the State agency generally concurred with our findings and recommendations and outlined its proposed corrective actions.