Medicare Compliance & Reimbursement

More states could come collecting if new information sharing pans out.

Drug manufactures, be ready: States that dropped the ball on drug rebate collections could soon revisit those transactions.
 
The Centers for Medicare & Medicaid Services will be heeding advice from a recent inspection report by the HHS Office of Inspector General, and working to improve information sharing between states that have collected rebates and those that have not.

According to the April 23 inspection report, Medicaid could have saved $30 million if all states had collected rebates for single-source physician-administered drugs -- and an additional $7 million for multiple-source drugs. A single year of savings from collected drug rebates would surpass the one-time cost of changing the infrastructure needed to effectively collect rebate.

In 2001, 24 states had not collected any drug rebates.

"It would be valuable for states that do not collect rebates for physician-administered drugs to know the ... what, where, when and why of resources needed, and how this process unfolded for states that have been down this road," the report reads.

The OIG also recommended CMS better educate state Medicaid directors on utilizing the Medicare crosswalk as a way to reducing administrative costs of setting up their own.

To read the report, titled "Medicaid Rebates for Physician-Administered Drugs" (OEI-03-02-00660), go to http://oig.hhs.gov/w-new.html.

Lesson Learned: Pharma companies can expect CMS to assist states in recovering uncollected millions.