Grassley Seeks Data On Medicaid Payments For Unapproved Treatments

Main Category: Medicare / Medicaid / SCHIP
Article Date: 15 Nov 2007 - 11:00 PDT

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Senate Finance Committee ranking member Chuck Grassley (R-Iowa) on Tuesday informed FDA and CMS that he is investigating whether Medicaid is making payments for unapproved prescription drugs, CongressDaily reports. To be eligible for Medicaid reimbursements, drug makers are required to register their products with CMS using FDA-assigned codes and receive FDA certification that the drugs are not classified as less than effective.

Grassley is investigating whether some companies are billing Medicaid for unapproved drugs using false codes. Grassley requested responses from FDA and CMS by Nov. 21 detailing programs they use to track which drugs are eligible for Medicaid reimbursements. In addition, he said the Department of Justice and HHS Office of Inspector General should work to help CMS recover improper payments. Grassley said, "If the allegations are true, then not only do we need to strengthen efforts to protect patient safety, but the federal government also should be recouping monies paid for these unapproved drugs" (CongressDaily, 11/14).

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