Pharmacies face extra audit burdens that threaten their existence

By Markian Hawryluk
Published 8 Min Read

Unsplash

The clock was about to strike midnight, and Scott Newman was desperately feeding pages into a scanner, trying to prevent thousands of dollars in prescription payments from turning into a pumpkin.

As the owner of Newman Family Pharmacy, an independent drugstore in Chesapeake, Virginia, he was responding to an audit ordered by a pharmacy benefit manager, an intermediary company that handles pharmacy payments for health insurance companies. The audit notice had come in January as he was scrambling to become certified to provide COVID-19 vaccines, and it had slipped his mind. Then, a month later, a final notice reminded him he needed to get 120 pages of documents supporting some 30 prescription claims scanned and uploaded by the end of the day.

Markian Hawryluk
From KHN

For reprint and licensing requests for this article, click here.


More From Employee Benefit News

Sign Up Form

Login Modal Form