Review of West Virginia's Medicaid Drug Rebate Program

EXECUTIVE SUMMARY:

The objective of this review was to determine whether West Virginia's Department of Health and Human Resources (DHHR) had established adequate accountability and internal controls over the Medicaid drug rebate program.  Generally, DHHR had established adequate accountability and internal controls.  However, we found that (1) outstanding rebates reported to the Centers for Medicare and Medicaid Services did not agree with the accounting records; (2) DHHR had not resolved disputes timely; (3) the rebate billing department and accounts receivable department maintained separate accounting records of rebate transactions without reconciling their records to one another; and (4) DHHR used an outdated policies and procedures manual for the Medicaid drug rebate program that was not approved by management.