States may get more agressive on rebate collections. The HHS Office of Inspector General continues to pore over state records nationwide to make sure Medicaid agencies are doing their job to secure drug rebates. It's all part of a long-running examination of one of the hottest compliance issues around for drugmakers. The fact that the feds are putting so much energy into the issue should be a heads up for drug manufacturers, since the cost of settling alleged fraud connected with rebates can be astronomical. In its latest round of reviews, the OIG assessed rebate accounting in five states and Washington, DC. Virginia, South Dakota, Minnesota and DC got good marks, according to the OIG, while Alabama had middling results. Hawaii and Washington had more serious problems, according to the agency, and need to take steps to get their act together. To see the reports, numbered A-03-03-00205, A-03-03-0208, A-04-03-06013, A-05-03-00045, A-07-03-04016 and A-10-03-00007, go to http://oig.hhs.gov/oas/oas/cms.html. Lesson Learned: Medicaid drug rebates remain a top compliance issues for pharmaceutical manufacturers.