Review of Ryan White Title II Funding in Maryland

For the period April 1, 2003, through March 31, 2006, the Maryland Department of Health and Mental Hygiene (the State agency) complied with the Ryan White CARE Act, Title II, payer-of-last-resort requirement that funds not be used to pay for drugs that are eligible for coverage by other Federal, State, or private health insurance. However, for the period April 1, 2000, through March 31, 2006, the State agency did not comply with the Federal requirement that reported expenditures include only drugs that the State agency actually purchased. Specifically, the State agency claimed $1.8 million in unallowable Title II expenditures for drugs that it authorized but never purchased.

We recommended that the State agency refund $1.8 million to the Federal Government for reported expenditures for drugs that it authorized but never purchased. In written comments on our draft report, the State agency concurred with our finding and said that it would refund the $1.8 million to the Federal Government.