Illinois owes the federal government at least $4 million for not collecting rebates for drugs administered by physicians to Medicaid patients in the state, according to a new audit by the U.S. Department of Health & Human Services’ inspector general.
Paid quarterly by drugmakers, rebates are meant to offset the costs of drugs prescribed to patients in the government-funded program for the poor and disabled. Manufacturers must participate for drugs to be eligible for federal reimbursement.
The report, released yesterday, found the state did not invoice manufacturers for rebates associated with $7.7 million of physician-administered drugs between Oct. 1, 2015, and Sept. 30, 2017. The federal government’s share totaled $4.1 million. (Read the report below.)
It also concluded Illinois did not submit enough data to determine whether it should have invoiced manufacturers for rebates associated with an additional $503,950—$258,640 of which is the federal government’s share.
In addition to refunding the federal government $4.1 million and working with the Centers for Medicare & Medicaid Services to determine if additional funds are owed, the inspector general recommends the state make adjustments to ensure it collects rebates for eligible physician-administered drugs.
According to the report, the state agreed with the recommendations. The Illinois Department of Healthcare & Family Services, the state agency that oversees Medicaid, did not respond to a request for comment.
The DHS inspector general decided to take a closer look at prescription drug claims after prior reviews found states did not always comply with federal requirements, the report says. Illinois is the 36th state to undergo such a review.
The federal government recently recommended New Jersey repay $8.1 million and that Indiana repay $710,420. So far, only five states have been found in compliance.