Review of Hemophilia Treatment Centers' Disposition of Program Income and Patient Choice for Factor Provider for Calendar Year 2000

EXECUTIVE SUMMARY:

The Health Resources and Services Administration (HRSA) requested the Office of Inspector General to review Hemophilia Treatment Centers' (HTCs) disposition of program income and their patient choice policies during calendar year 2000.  The HTCs earn program income when they purchase blood-clotting factor and related drugs at discount prices pursuant to participation in the 340B program and resell them to HTC patients.

We found that the HTCs generally used program income for patient care and related activities, and had choice policies in place that allowed patients to obtain the blood clotting factor they needed from providers of their choice.  At one of the six HTCs we visited, however, we found:  (1) inappropriate use of program income; and (2) inappropriate Medicaid billing practices resulting in overbilling of $613,000.  We recommended that HRSA develop program guidelines, improve monitoring of HTCs, and work with the Centers for Medicare and Medicaid Services to ensure that the overpayment of $613,000 is refunded to the Medicaid program.  The HRSA generally agreed with our findings and recommendations.