Audit of the Medicaid Drug Rebate Program in Wyoming

The objective of this audit was to evaluate whether the Wyoming Department of Health Pharmacy Unit (the State agency) had established adequate accountability and internal controls over the Medicaid drug rebate program.   We found the State agency lacked sufficient internal controls with regard to the Medicaid drug rebate program as required by federal rules and regulations.  The State agency did not develop or follow adequate policies and procedures with regard to the drug rebate program and its management by Affiliated Computer Services, a company the State agency contracted with to administer the drug rebate program.  Further, the State agency did not have reasonable assurance that drug rebate balances and collections reported to the Centers for Medicare and Medicaid Services were accurate.  We believe that the State agency could increase its drug rebate collections by using the State Agency's hearing mechanism to resolve disputes.  Moreover, the lack of sufficient internal controls increased the risk for fraud, waste, or abuse of drug rebate program funds.