Michigan Medicaid: Diabetes/Weight Loss Drugs Dispensed Per Requirements

HHS OIG Reports & Publications

Published March 26th, 2026

Detected March 27th, 2026

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.

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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.

Source document (simplified)

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.