A recent audit by the Department of Health and Human Services Office of Inspector General has revealed inconsistencies in how states report data on Medicaid drug costs. This raises concerns about the accuracy of drug spending data used to oversee the program. The audit found that some states were not consistently verifying data on how much pharmacies were reimbursed for dispensing drugs to Medicaid patients enrolled in managed care plans.
Out of the 36 states that covered outpatient prescription drugs for Medicaid through managed care plans in January 2022, 28 states required the plans to report the paid amounts for drugs. However, the audit found that some states did not consistently validate this data. This could potentially lead to errors in reporting drug costs, impacting the oversight and management of Medicaid drug spending.
The findings of the report suggest a need for improved data validation processes to ensure the accuracy of Medicaid drug spending data. By implementing more stringent validation measures, states can enhance the transparency and reliability of the information used to oversee and manage drug costs within the Medicaid program. Ultimately, this will help to ensure that Medicaid beneficiaries receive quality care while maintaining the financial integrity of the program.
