Retail News Breaks
More states push PBM audit legislation
April 30th, 2012
ALEXANDRIA, Va. – Mississippi and Minnesota are the latest states to offer legislation to curb audits of pharmacies by pharmacy benefit managers (PBMs).
The National Association of Chain Drug Stores late last week applauded the enactment of PBM audit legislation in Mississippi and voiced its support of a similar bill put before the governor of Minnesota.
NACDS said Mississippi Gov. Phil Bryant (R.) signed HB 1490 into law last week. The bill was introduced Feb. 23 by State Rep. Eugene Forrest Hamilton (R.).
Among other provisions, the law will set procedures for conducting an audit under the Mississippi's Pharmacy Audit Integrity Act and authorize monetary penalties to PBMs for noncompliance with the act.
NACDS thanked the Mississippi Independent Pharmacy Association for its leadership in advocating for the new law, which is slated to become effective July 1.
"The enactment of this legislation is another step forward for pharmacy patient care and for sound public policy," NACDS president and chief executive officer Steve Anderson said in a statement. "The new law says it best when it requires auditors to 'not interfere with the delivery of pharmacist services to a patient' and to 'utilize every effort to minimize inconvenience and disruption to pharmacy operations.' The Mississippi legislature and Gov. Bryant deserve credit for advancing this pro-patient and pro-pharmacy law."
In Minnesota, Gov. Mark Dayton (D.) was urged by NACDS to enact the Pharmacy Audit Integrity Program (HF 1236/SF 973), which would establish standards for PBM audits of pharmacies in the state.
NACDS said it sent a letter of support to the Dayton prior to enactment, stressing the importance of the legislation in ensuring transparency in the PBM audit process.
"The legislation places reasonable limits and terms on the performance and conduct for pharmacy audits such as PBM notification to pharmacies if the terms of a contract are changed, providing advance notice of an audit so that the pharmacy can have appropriate records and staff available to assist in the audit and setting appropriate limits on the scope, timing, and performance of audits so that audits are not disruptive to pharmacy services," Anderson stated. "Importantly, the legislation also places appropriate limits on payment to auditors and conditions on when a PBM may recoup money from the pharmacy, as well as establishes an appeals process for pharmacies to contest audit results."
Earlier this month, NACDS hailed the enactment of legislation in Kentucky that would require transparency in PBM pharmacy audits and prohibit PBMs from seeking to recoup payments when there's no evidence of fraud. And in March, NACDS and the National Community Pharmacists Association lauded the Utah state legislature for passing a bill that would require PBM audits of pharmacies to be fair and rational.
Also in March, NACDS and NCPA 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.
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