Selected Diabetes and Weight Loss Drugs Were Dispensed to Michigan Medicaid Managed Care Enrollees in Accordance With Federal and State Requirements

Why OIG Did This Audit

• There has been a substantial increase in the use of certain diabetes and weight loss drugs in recent years. Certain diabetes drugs initially approved by the Food and Drug Administration (FDA) to help control blood sugar levels for individuals with type 2 diabetes are known to be highly effective weight loss agents. FDA later approved these and similar drugs specifically for weight loss.
• A prior OIG audit identified that national Medicaid gross spending on selected diabetes and weight loss drugs increased by 540 percent from 2019 to 2023, totaling $9.4 billion in 2023.
• This audit determined whether selected diabetes and weight loss drugs were dispensed to Michigan Medicaid managed care enrollees in accordance with Federal and State requirements.

What OIG Found

• During our audit period, selected diabetes and weight loss drugs were dispensed to Michigan Medicaid managed care enrollees in accordance with Federal and State requirements.
• Michigan ensured that the managed care organizations followed all outpatient prescription drug coverage and utilization requirements that were in place during our audit period, including prior authorizations and quantity limits, for all 105 encounter claims in our stratified random sample.

What OIG Recommends

This report does not contain recommendations.

Michigan informed us that it did not have comments on our draft report.

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