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Medicaid Drug Rebate Program

In 1991, Medicaid started the National Drug rebate program, which in two years showed was not collecting rebates at the rate anticipated, as brand drug manufacturers were disputing large amounts “weren’t their drugs”.

So, in November 1994, HCFA [CMS in 2000] started a “Dispute Resolution Program”, that continues unsuccessfully today; while back in 1994 I informed them the major cause of “disputes” was mislabeled repackaged brand-named drugs. HCFA, the FDA and eventually, the Justice Department and states Medicaid Fraud Control Units in a dozen states wouldn’t speak to me.

Now HHS has released advice to all the states, on these unpaid and disputed rebates at https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/dispute-resolution/index.html “The Office of Inspector General (HHS,OIG) conducts regular multi-state reviews of the Medicaid Drug Rebate Program, and have identified many states with inaccurate or incomplete drug rebate records and large amounts of outstanding disputes. In an effort to respond to the OIG’s findings., many states have contacted CMS for suggestions on how to resolve outstanding disputes from the early years of the rebate program where the data needed to resolve the dispute is unreliable and/or unavailable.” https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/downloads/drp-aged-disputs.pdf

I collected, analyzed and retained all the public records since 1991, consisting of all states Medicaid Drug Utilization and their Medicaid Financial Management Reports, and found $57 billion in unpaid rebates and provided these two years ago to all 10 HHS Regional Office Drug Rebate Dispute Coordinators and show a state by state report of missing $30 billion in HHS/CMS rebates and $27 billion in missing state Rebates! I show all ststes taxpayer funds involved in my eBook: On the Q.T.!  HHS.OIG doesn’t know how to do Fraud Audits! While I did all their work!

 

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