Pharmacy Benefit Manager Oversight and Audit

Pharmacy Benefit Managers: History, Business Practices ...

Pharmacy benefit managers (PBMs) play a major role in the provision of pharmacy services by acting as intermediaries between pharmacies, plan sponsors.

Secretary of State Audit Confirms PBMs Need More Oversight

According to the report, PBM transactions in the Oregon Medicaid prescription drug program are too complex and hidden for accountability.

Auditor General says DHS failed to oversee pharmacy benefit ...

A pharmacy manager retrieves medication. (Photo by Joe Raedle/Getty Images). Pennsylvania Auditor General Tim DeFoor has released a report ...

The District of Columbia Has Taken Significant Steps To Ensure ...

Spread pricing occurs when a managed care organization (MCO) contracts with a pharmacy benefit manager (PBM) to manage its prescription drug ...

Oversight of Pharmacy Benefit Managers

PBMs administer prescription drug coverage by acting as an intermediary between pharmacies, drug manufacturers, and consumers. The number of PBMs operating in ...

DFS Superintendent Harris Proposes Pharmacy Benefit Manager ...

This proposed regulation seeks to put an end to unfair practices by the PBM industry, making prescription drugs more affordable and accessible for New Yorkers.

State Auditors Find Complexity Around Pharmacy Benefit Managers ...

SALEM, OR — The Oregon Audits Division released its latest audit of the Oregon Health Authority today, focused on Medicaid and the role of Pharmacy Benefit ...

Oregon should improve oversight of insurers' prescription drug ...

Other states better protect patients and pharmacies from the practices of pharmacy benefit managers, known as PBMs, auditors found.

Auditor General DeFoor to Release Performance Audit ... - Facebook

Pennsylvania Auditor General Timothy L. DeFoor will join State Senator Devlin Robinson, State Senator Judy Ward, State Representative ...

Medicaid MCO PBM Pricing - Office of Inspector General

MCOs may contract with pharmacy benefit managers (PBMs) to manage or administer the prescription drug benefits on their behalf.

Pharmacy Benefit Manager Oversight

The worrisome practices of PBMs are not restricted to state. Medicaid programs but affect all plan sponsors that utilize. PBMs, including state government ...

Pharmacy Benefits Managers (PBMs) - SC Department of Insurance

Regulation 69-77 has been amended to implement that portion of Act No. 30 of 2023 providing for external review of certain Pharmacy Benefit Manager (PBM) ...

Current issues and recommendations to manage prescription drug ...

These issues exist in a complex contractual environment where minimal oversight of pharmacy claim adjudication and reimbursement practices can occur.

Molina Healthcare, Inc. Pharmacy Benefit Manager Oversight and ...

This PBM Oversight and Surveillance Program description provides a detailed description of all three cycles of our PBM oversight program to ...

House Passes Prescription Drug Access, Pharmacy ... - Press Room

House Passes Prescription Drug Access, Pharmacy Benefit Manager Oversight Bill. July 24, 2024. The Massachusetts House of Representatives today passed major ...

Managed Care Organizations: Oversight of Pharmacy Benefit ...

Managers and Reporting of Pharmacy Encounter Data. Financial Audit Division, Released May, 2019. The Department of Human Services (DHS) is responsible for ...

oversight of pharmacy benefit managers department of insurance

A copy of this report is available for public inspection at the Baton Rouge office of the. Louisiana Legislative Auditor. This document is ...

Auditor McGuiness: Time to Reform Pharmacy Benefit Manager's ...

State Auditor Kathy McGuiness today released the following statement regarding proposed regulations for pharmacy benefit managers.

Task Force on Pharmacy Benefit Management Reporting

PBMs are health care companies that contract with health plans to manage pharmacy benefits and negotiate manufacturer rebates. Notable provisions of AB 315 ...

Press Release • Ohio Auditor of State

Auditor's Report: Pharmacy Benefit Managers Take Fees of 31% on Generic Drugs Worth $208M in One-Year Period.