Department of Health
Maintenance of the Medicaid Prescription Drug File
According to State law, the amounts to be paid to pharmacies seeking reimbursement for prescription drugs dispensed to Medicaid recipients are to be based on monthly drug pricing information provided by an independent drug pricing clearinghouse. This information is maintained in an automated file by the Department of Health. We examined the actions taken by the Department in maintaining this file and found that improvements were needed, as the information was not always accurate and up-to-date. As a result of the inaccuracies that we identified, during our two-year audit period, pharmacies were overpaid about $600,000 and federal reimbursements of about $1.3 million were not collected by the Department. We recommended that the Department seek the federal reimbursements (the overpayments may not be recoverable), and make certain improvements in its maintenance of the prescription drug file.
For a complete copy of Report 2001-S-58 click here.
For a copy of the 90-day response click here.
For a copy of the associated follow-up report click here.