Department of Health and Human Services

Office of Inspector General -- AUDIT

"Audit of Six Ulcer Treatment Drugs Reimbursed Under the Illinois Medicaid Prescription Drug Program," (A-06-92-00008)

September 29, 1992


Complete Text of Report is available in PDF format (1.08 MB). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.

EXECUTIVE SUMMARY:

This final report presents the results of our review of six ulcer treatment drugs reimbursed under the Illinois Medicaid prescription drug program. The Omnibus Budget Reconciliation Act of 1990 (OBRA '90) requires the State Medicaid agencies to operate drug use review programs on an ongoing basis. One of the standards recognized by OBRA '90 is the manufacturers' recommended dosages. We concluded that the Illinois Department of Public Aid (State agency) did not have any restrictions pertaining to the manufacturers' recommended dosages for ulcer treatment drugs. Accordingly, our review showed that about $5.82 million (Federal share $2.91 million) in cost savings could have been realized for Calendar Year 1990 had the State agency limited payment for these drugs to the amount needed to pay for the manufacturers' recommended dosages.