Michigan Medicaid: Diabetes/Weight Loss Drugs Dispensed Per Requirements
Summary
The HHS Office of Inspector General (OIG) reported that selected diabetes and weight loss drugs dispensed to Michigan Medicaid managed care enrollees were in accordance with federal and state requirements. The audit found that Michigan ensured managed care organizations followed all applicable coverage and utilization requirements, including prior authorizations and quantity limits.
What changed
The HHS Office of Inspector General (OIG) has issued a report (OAS-25-05-067) finding that Michigan Medicaid managed care organizations dispensed selected diabetes and weight loss drugs in compliance with federal and state requirements during the audit period. The audit reviewed 105 encounter claims and confirmed that all outpatient prescription drug coverage and utilization requirements, such as prior authorizations and quantity limits, were followed.
This report does not contain recommendations, and Michigan did not have comments on the draft report. This finding indicates that for the period audited, no corrective actions are required from Michigan Medicaid or its managed care organizations regarding the dispensing of these specific drugs. Compliance officers should note this positive finding for the state's adherence to existing regulations.
Archived snapshot
Mar 27, 2026GovPing captured this document from the original source. If the source has since changed or been removed, this is the text as it existed at that time.
Selected Diabetes and Weight Loss Drugs Were Dispensed to Michigan Medicaid Managed Care Enrollees in Accordance With Federal and State Requirements
Issued on
03/26/2026
| Posted on
03/27/2026
| Report number: OAS-25-05-067
Report Materials
Why OIG Did This Audit
- There has been a substantial increase in the use of certain diabetes and weight loss drugs in recent years. Certain diabetes drugs initially approved by the Food and Drug Administration (FDA) to help control blood sugar levels for individuals with type 2 diabetes are known to be highly effective weight loss agents. FDA later approved these and similar drugs specifically for weight loss.
- A prior OIG audit identified that national Medicaid gross spending on selected diabetes and weight loss drugs increased by 540 percent from 2019 to 2023, totaling $9.4 billion in 2023.
- This audit determined whether selected diabetes and weight loss drugs were dispensed to Michigan Medicaid managed care enrollees in accordance with Federal and State requirements.
What OIG Found
- During our audit period, selected diabetes and weight loss drugs were dispensed to Michigan Medicaid managed care enrollees in accordance with Federal and State requirements.
- Michigan ensured that the managed care organizations followed all outpatient prescription drug coverage and utilization requirements that were in place during our audit period, including prior authorizations and quantity limits, for all 105 encounter claims in our stratified random sample.
What OIG Recommends
This report does not contain recommendations.
Michigan informed us that it did not have comments on our draft report.
Report Type Audit HHS Agencies Centers for Medicare and Medicaid Services Issue Areas Financial Stewardship Prescription Drug Target Groups – Financial Groups Medicaid
Notice
This report may be subject to section 5274 of the National Defense Authorization Act Fiscal Year 2023, 117 Pub. L. 263.
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