Where To Report Waste

Fraud, Abuse, Or Retaliation

Georgia Did Not Always Invoice Rebates to Manufacturers for Pharmacy and Physician-Administered Drugs

Submitting OIG:

Department of Health & Human Services OIG

Date Issued:

Monday, March 13, 2023

Agency Reviewed / Investigated:

Department of Health & Human Services

Submitting OIG-Specific Report Number:

A-04-21-08089

Component, if applicable:

Centers for Medicare & Medicaid Services

Centers for Medicare and Medicaid Services

External entity, if applicable:

Georgia Department of Community Health

Location(s):

US

Gabon

Type of Report:

Audit

Questioned Costs:

$2,308,312

Funds for Better Use:

$0

Number of Recommendations:

1

View Document:

Attachment	Size
42108089.pdf	2.4 MB

Related Open Recommendations

Recommendation Number	Recommendation Status	Significant Recommendation	Additional Details
23-A-04-054.01	Open	No
We recommend that the Georgia Department of Community Health refund to the Federal Government $644,802 (Federal share) for single-source physicianadministered drug claims that were ineligible for Federal reimbursement.
23-A-04-054.02	Open	No
We recommend that the Georgia Department of Community Health refund to the Federal Government $9,325 (Federal share) for top-20 multiple-source physician-administered drug claims that were ineligible for Federal reimbursement.
23-A-04-054.03	Open	No
We recommend that the Georgia Department of Community Health work with CMS to determine and refund the unallowable portion of $52,837 (Federal share) for other multiple-source physician-administered drug claims that may have been ineligible for Federal reimbursement and consider invoicing drug manufacturers for rebates for those drug claims that CMS determines are allowable;