Wisconsin Department of Social and Health Services, DAB No. 1387 (1993)

Department of Health and Human Services

DEPARTMENTAL APPEALS BOARD

Appellate Division

SUBJECT:  Wisconsin Department  of Social and   Health Services

DATE:  February 1, 1993
Docket No. A-92-54
Decision No. 1387

DECISION

The Wisconsin Department of Social and Health Services (Wisconsin)
appealed a determination by the Health Care Financing Administration
(HCFA) disallowing $529,568 in federal financial participation (FFP)
claimed by Wisconsin under the Medicaid program during the period July
1, 1983 through June 30, 1989.  HCFA determined that Wisconsin had
claimed FFP for drug products that were ineligible for Medicaid
reimbursement because the drug products had been deemed either
ineffective or "identical, related, or similar" (IRS) to ineffective
drugs.   HCFA disallowed FFP for numerous drug products, with the
majority of the disallowed FFP being for the drugs dipyridamole and
Naldecon. 1/

In LTE and IRS Drug Disallowances, DAB No. 1366 (1992), the Board
reviewed HCFA disallowance determinations received by 14 states.  While
the drug products involved in these appeals varied from state to state,
three drug products -- dipyridamole, Naldecon, and Bellergal --  were
predominant, and the Board specifically addressed each of these drugs.

After reviewing DAB No. 1366, Wisconsin withdrew its appeal in this case
except for those claims arising from dipyridamole and Naldecon and
agreed to the issuance of a summary decision by the Board to resolve the
disallowances for those drug products.  HCFA also agreed that DAB No.
1366 should serve as the basis for a summary Board decision with respect
to dipyridamole and Naldecon.

In DAB No. 1366, we concluded in relevant part as follows:

 o       We find that dipyridamole is eligible for retroactive
 reimbursement, and we therefore reverse the disallowances for
 that product.

 o       We find that it was unreasonable to expect the States to
 identify Naldecon and the Naldecon-related drugs as IRS to
 Dimetapp [a drug found to be ineffective], and we therefore
 reverse the disallowances for those drugs.  However we sustain
 any disallowance for the period after the issuance of the
 September 1989 State Medicaid Manual, which provided notice to
 the States that Naldecon was IRS. . . . 2/

At 39.

Conclusion

Accordingly, based on the analysis in DAB No. 1366, which we incorporate
by reference, we reverse the disallowances for dipyridamole and
Naldecon.  Additionally, as we provided for in DAB No. 1366, if
Wisconsin believes itself adversely affected by HCFA's recalculation of
the disallowance amount, it may appeal that recalculation determination
to the Board within 30 days of that determination.


       _____________________________
       Donald F. Garrett


       _____________________________ M. Terry
       Johnson


       _____________________________ Norval D.
       (John) Settle Presiding Board Member


1.  For our purposes here, Naldecon also includes other drug products
that are "Naldecon-related," such as drug products which have among
their ingredients either more than one decongestant or more than one
antihistamine.

2.  Since the audit period in this appeal was from July 1, 1983 through
June 30, 1989, our affirmation in DAB No. 1366 of disallowances for
Naldecon after the issuance of the September 1989 State Medicaid Manual
is not applicable to Wisconsin