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Series: Audits of Medicaid Select Diabetes and Weight Loss Drugs

Announced on  | Last Modified on  | Series Number: SRS-A-26-013
Status
Active
Agency
Centers for Medicare and Medicaid Services

OBJECTIVE

Medicaid utilization of and gross spending on select diabetes and weight loss drugs have rapidly increased in recent years. The select diabetes drugs were approved to help control blood sugar levels for individuals with type 2 diabetes; however, these drugs are known to be used for weight loss. Most States cover these drugs to treat Medicaid enrollees with diabetes. Additionally, some States cover similar types of drugs that were approved for weight loss. We will identify national Medicaid utilization for select diabetes and weight loss drugs and select one or more States to review.

There are 3 projects in this series.

Project titles will remain unpublished until projects are complete and reports are posted.

ACTIVE PROJECTS IN THIS SERIES (1)

Project WA-24-0036 • Announced on Mar 15, 2024

COMPLETED PROJECTS IN THIS SERIES (2)

Audit of Diabetes and Weight Loss Drugs Dispensed to Michigan Medicaid Managed Care Enrollees

Project OAS-25-05-067 • Completed on March 26, 2026

Medicaid Gross Spending on Diabetes and Weight Loss Drugs in 2023

Project A-05-24-00016 • Completed on December 16, 2024

TIMELINE

  • March 15, 2024
    Series Number SRS-A-26-013 Assigned
  • March 15, 2024
    Projects Announced

    Project WA-24-0036

  • Medicaid Gross Spending on Diabetes and Weight Loss Drugs in 2023 - A-05-24-00016

  • December 16, 2024
    Project Complete - A-05-24-00016

    Medicare Program Oversight has been marked as complete. Report Published

  • March 5, 2025
    Project Announced

    Audit of Diabetes and Weight Loss Drugs Dispensed to Michigan Medicaid Managed Care Enrollees - OAS-25-05-067

  • March 26, 2026
    Project Complete - OAS-25-05-067

    Audit of Diabetes and Weight Loss Drugs Dispensed to Michigan Medicaid Managed Care Enrollees complete. Report Published

  • Today
    1 Project In-Progress
  • Est FY2026
    Estimated Fiscal Year for Series Completion

2 REPORT PUBLISHED

Selected Diabetes and Weight Loss Drugs Were Dispensed to Michigan Medicaid Managed Care Enrollees in Accordance With Federal and State Requirements (OAS-25-05-067)
  • 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.
Recommendations are updated each month and may not immediately be available for recently completed projects.
Work Plan Type
Office of Audit Services
HHS Agencies
Centers for Medicare and Medicaid Services
Issue Areas
Departmental Operational Issues Financial Stewardship Food, Drug and Device Safety Prescription Drug Public Health Issues
Target Groups
-
Financial Groups
Medicaid