Florida Fair Audit Press Conference with Senator Aaron Bean

Tallahassee, Fla. -- Pharmacy Choice and Access Now (PCAN) -- a coalition of consumers, local businesses and pharmacists across the nation committed to preserving quality and affordable health care -- today hosted a press conference highlighting the Senate Health Policy Committee and Senate Regulated Industries Committee's passage of legislation beneficial to the pharmacy community and consumers (SB 702) and to encourage the House of Representatives to vote in favor of similar legislation (HB 745). Senator Aaron Bean, Representative Travis Cummings, pharmacists and members of the healthcare community from across Florida gathered outside the Florida Senate chamber to voice the importance of reasonable standards for pharmacy audits that treat pharmacists fair and keep patients first. Pharmacy Benefit Managers (PBMs) routinely audit pharmacies to ensure claims are submitted and handled properly. However, audits have become increasingly time-consuming and now regularly take pharmacists away from their top priority, their patients. SB 702 and HB 745 include straightforward, common-sense auditing standards that will benefit both community pharmacies and their patients. These standards include: · One week prior notice before conducting an audit · Audits that require clinical or professional judgment be conducted by or in consultation with a pharmacist · No penalties or financial recoupment for simple clerical, typographical, scrivener's or computer errors if the prescription was properly and correctly dispensed unless a pattern of such errors exists, fraudulent billing is alleged or errors result in financial loss to the sponsor · Prohibits the use of extrapolations in auditing claims · Allowing 10 days for pharmacists to produce documentation to address any discrepancies found during the audit · Delivery of preliminary audit reports to pharmacists within 120 days after an audit is completed · The Office of Insurance Regulation will investigate pharmacy complaints of willful violations of audit provisions by PBMs · Limits auditing period to two calendar years after the prescription is submitted or adjudicated With these responsibilities in mind, a pharmacist's time and effort should be focused first and foremost on serving their patients. But with the increasingly unpredictable and unfair claims place by auditors of PBMs in Florida, it is becoming more difficult for pharmacies to serve patients and manage their day-to-day challenges as a business. In a recent survey of Florida community pharmacists, nearly half had dispensing records older than two years audited, nearly 90 percent have been penalized for non-fraudulent clerical errors and 95 percent feel that they have no power to negotiate terms of contracts PBMs. PCAN supports SB 702 and HB 745 because they address some of the auditing issues that pharmacists face. This legislation will streamline the auditing process and will ensure pharmacists spend more time with patients instead of paperwork. "Pharmacists work constantly to make certain they are in compliance in order to ensure the safety and security of the patients they serve," said Bill Mincy, BPharm, Vice President of Business Development for PPSC and National Board Chair for PCAN. "These audits are increasingly unpredictable and have become an unfair practice by PBMs in Florida. Something must be done to rein in this process and I believe this legislation is a step in the right direction." "Pharmacies employ tens of thousands of Floridians and bring hundreds of millions in revenue to our state," said Senator Aaron Bean. "SB 702 establishes predictable and fair auditing practices to help pharmacists focus on the health and wellness of their patients." "HB 745 provides for straightforward auditing that lets pharmacists prepare for audits efficiently," said Representative Travis Cummings. "This legislation also ensures that audits take place for the right reasons, examines the right records and completes the process at the right time." "As with all business practices, auditing is a valuable tool to catch fraud, waste and abuse," said Michael Jackson, Executive Vice President and CEO of the Florida Pharmacy Association and member of PCAN. "It is important that pharmacy audits remain effective, but come with some practical, predictable standards for pharmacists." Florida's more than 2,700 pharmacies bring over $350 million in tax revenue to our state, and employ over 32,000 people with an estimated payroll over $1.1 billion. Pharmacies are the primary provider of prescription medications and pharmacists are the medication experts Floridians rely on. As highly accessible -- and trusted -- health providers, pharmacists enhance health and wellness through counseling, medication therapy management, immunizations, testing and more.