The Office of Inspector General ("OIG") Issues Report Comparing Medicare Part D and Medicaid Pharmacy Reimbursement Amounts

On February 27, 2009, the OIG issued a report comparing Medicare Part D and Medicaid pharmacy reimbursement amounts for selected drugs at the national level.  The OIG found that the average Part D and Medicaid pharmacy reimbursement amounts were similar for most of the selected drugs.  There was less than a five percent difference between Part D and Medicaid amounts.  Additionally, the average unit ingredient costs were very similar.

The OIG also found that Medicaid pharmacy reimbursement amounts generally exceeded the average Part D reimbursement amounts for selected multiple-source drugs.  The Medicaid ingredient cost exceeded the average Part D ingredient cost for more than half of the multiple-source drugs reviewed.  The Medicaid dispensing fee exceeded the average Part D dispensing fee for these multiple-source drugs by at least 55 percent.

CMS agreed with the OIG’s findings.