Retail News Breaks
Alabama enacts PBM pharmacy audit legislation
May 14th, 2012
ALEXANDRIA, Va. – The National Association of Chain Drug Stores applauded Alabama Gov. Robert Bentley (R) for signing into law the Pharmacy Audit Integrity Act (SB 383), which regulates pharmacy audits conducted in the state by pharmacy benefit managers (PBMs).
NACDS said Friday that SB 383 sets uniform standards for the auditing of pharmacy records and includes requiring two weeks written notice of an audit.
In addition, the law mandates that audits involving clinical or professional judgment be done in consultation with a pharmacist, and it establishes an appeals process, among other provisions.
"We thank Gov. Bentley for signing this important pro-patient, pro-pharmacy legislation to curb tactics used by some PBMs that take away from the important business of improving patient health and making health care delivery more efficient and cost-effective," NACDS president and chief executive officer Steve Anderson said in a statement. "We thank the Alabama Pharmacy Association for their leadership in helping to ensure transparency in the PBM audit process."
Over the past couple of months, several states have implemented PBM pharmacy audit measures.
In late April, Mississippi enacted HB 1490, which sets procedures for conducting an audit under the state's Pharmacy Audit Integrity Act and authorize monetary penalties to PBMs for noncompliance with the act. Meanwhile, Minnesota enacted the Pharmacy Audit Integrity Program (HF 1236/SF 973), which establishes standards for PBM audits of pharmacies in the state. Also in April, Kentucky approved a bill requiring transparency in PBM pharmacy audits and prohibiting PBMs from seeking to recoup payments when there's no evidence of fraud.
And in March, NACDS hailed the Utah state legislature for passing a bill that would require PBM audits of pharmacies to be fair and rational. That month NACDS also endorsed federal legislation — the Medicare Pharmacy Transparency and Fair Auditing Act (H.R. 4215), introduced by Rep. Cathy McMorris Rodgers (R., Wash.) — that would set Medicare standards for pharmacy audits and reimbursement by PBMs.
NACDS, too, has voiced its support for the Pharmacy Competition and Consumer Choice Act, which includes provisions requiring transparency by PBMs in pharmacy audits. The bipartisan bill (S. 1058 and H.R. 1971) is sponsored by Sen. Mark Pryor (D., Ark.) and McMorris Rodgers.
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