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Department of Health and Human Services

Office of Inspector General -- AUDIT

"Audit of the Medicaid Drug Rebate Program in Nevada," (A-09-03-00033)

August 15, 2003

Complete Text of Report is available in PDF format (861 KB). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


The objective of this review was to evaluate whether the Nevada Division of Health Care Financing and Policy (the State agency) had established adequate accountability and internal controls over the Medicaid drug rebate program.  We found that the State agency had not established adequate policies, procedures, and internal controls over its drug rebate program.  Specifically, we identified weaknesses in the following areas:  (1) accounts receivable system, (2) rebate billings, (3) interest accrual and collection, and (4) dispute resolution.  As a result, the State Agency did not properly report drug rebate information to Centers for Medicare and Medicaid Services nor adequately establish policies, procedures, and internal controls to account for drug rebate program transactions.  In addition, the lack of adequate internal controls increased the risk for delayed collection of drug rebate funds and the potential loss of interest that could have been collected.  The State agency concurred with our findings and recommendations.