Florida Lawmakers Propose Reforms to Abusive Audits that Undermine Patient Care, Pharmacists and State Revenue
Alexandria, Va. Feb. 10, 2014 - Two Florida lawmakers have introduced legislation in the Florida State Senate and Florida House of Representatives, respectively, that would apply common sense standards to pharmacy audits and rein-in abusive practices that are harming patient care, small business community pharmacies and state revenue, the National Community Pharmacists Association (NCPA) said today.
"With SB 702, there can be clear guidelines of acceptable audit practices of our pharmacies," said Senator Bean. "I am hopeful these guidelines will result in better health care for all Floridians."
"I feel it is important that Florida remains a state that champions small business rights by removing unnecessary burdens that could otherwise jeopardize their future and those that use their service," said Representative Cummings. "The auditing process can be very burdensome and arduous on pharmacies, especially small independent pharmacies. The bill establishes the ‘rules of engagement' for the auditing process because right now there are none. HB 745 will establish fairness while still maintaining a high standard of service for the consumer, and I look forward to working to pass this much needed legislation in the State of Florida."
"It should not be a punishable offense when a pharmacist dispenses the right medication as prescribed to the right patient at the right time and for the agreed-upon reimbursement," said NCPA CEO B. Douglas Hoey, RPh, MBA. "Yet across the Sunshine State, pharmacists are struggling with egregious audits focused on hyper-technical clerical issues. These time-consuming reviews limit pharmacists' ability to care for patients. In addition, auditors seek any excuse, no matter how small, to take thousands of dollars away from pharmacies and local communities and send them out-of-state to Fortune 500 pharmaceutical middlemen."
"This legislation will allow reasonable pharmacy audits to continue in order to guard against waste, fraud and abuse," Hoey added. "NCPA is proud to support the work of the Florida Pharmacy Association, PPSC and all Florida pharmacists in this effort. We commend Senator Bean and Representative Cummings for their leadership and encourage their colleagues to support this legislation."
Rather than legitimately using the audit process to guard and protect against fraud, many pharmacy benefit managers (PBMs) view audits as a profitable revenue stream for their company. Community pharmacies are often forced to pay thousands of dollars as the result of an audit for nothing more than basic clerical or typographical mistakes, many of which are not the fault of the pharmacist or pharmacy staff. Twenty-nine other states have recently enacted bipartisan legislation similar to the Florida proposals and federal Medicare officials have admonished audit abuses by Medicare drug plans.
Florida is home to more than 445 independent community pharmacies that employ approximately 4,405 residents.