Share:
Senate Co-Sponsorship Memoranda
Senate of Pennsylvania
Session of 2015 - 2016
Regular Session
MEMORANDUM
| Posted: | February 17, 2015 04:18 PM |
|---|---|
| From: | Senator Richard L. Alloway, II |
| To: | All Senate members |
| Subject: | Pharmacy Audit Integrity Legislation |
| In the near future, I will be re-introducing legislation which would create a Pharmacy Audit Integrity Act to protect pharmacies from unfair auditing practices. Currently, no oversight or procedural requirements are in place for the audits performed on pharmacies in Pennsylvania. This legislation would specify procedures for auditing pharmacy records by various health care entities including managed care companies, insurance companies and pharmacy benefits managers. Among the procedures implemented include: providing the pharmacy with adequate notice prior to conducting an on-site audit, that audits must be conducted applying only the applicable Federal or Commonwealth of Pennsylvania laws and regulations and allowing for a specific appeal and review process. Additionally, extrapolation audits, which assess final audit results based only on a sample size, would be specifically prohibited. The proposed legislation does not prohibit audits from occurring. In fact, it allows for full recovery of finances in any case where fraud or abuse has occurred. The legislation simply sets reasonable standards for fair and uniform audit procedures. These standards would protect pharmacies from being burdened with costly penalties in cases where no fraud or financial loss has occurred and where a simple clerical or typographical error was the only mistake made. Similar legislation was introduced last session in the Senate as Senate Bill 831 and was previously co-sponsored by Sens. Argall, Blake, Browne, Fontana, Hughes, Scarnati, Vulakovich, White, Yaw, and Yudichak. Thirty-one states have passed some form of fair and uniform pharmacy legislation, including the bordering state of Maryland. |
Introduced as SB668