Alexandria, Va. - Aug 27, 2012
Pennsylvania state lawmakers should join the growing number of states passing legislation to set common-sense standards for pharmacy audits, the National Community Pharmacists Association (NCPA) said in a letter to Keystone State leaders. In its letter, NCPA calls on Pennsylvania state legislators to favorably move H.B.727.
"This important legislation is based on a simple principle: When a pharmacist dispenses the right medication to the right patient at the right time, as prescribed by a doctor, it should not be a punishable offense," said NCPA CEO B. Douglas Hoey, RPh, MBA. "Pharmacists recognize the need for legitimate audits to protect public and private health plans from waste, fraud and abuse. However, pharmacy auditing practices are out of control. Time-consuming, abusive audits compromise pharmacists' availability to counsel patients. Increasingly, they appear to be more about generating revenue for the middleman than rooting out fraud."
Accompanying NCPA's letter was a sampling of abusive auditing experiences from some of the 1,000 independent community pharmacies in Pennsylvania. In one case, a health plan sought to recoup $250,000 from a pharmacy when the pharmacist filing a claim for reimbursement used what was a valid physician's prescriber number for that particular doctor, but not the prescriber number preferred by the plan. "A quarter of a million dollars when no ill intent was intended and no error was even made, harm done to any consumer, or money lost by any party involved," the pharmacist lamented.
More than 20 states have enacted similar bills into law and 10 of those states—Alabama, Indiana, Kentucky, Louisiana, Maryland, Minnesota, Mississippi, South Carolina, Utah and Vermont—have enacted or strengthened such laws in just the past five months. In California, such a measure recently passed both chambers of the state legislature.
The National Community Pharmacists Association (NCPA®) represents the interests of America's community pharmacists, including the owners of more than 23,000 independent community pharmacies. Together they represent a $93 billion health care marketplace, dispense nearly 40% of all retail prescriptions, and employ more than 315,000 people, including 62,400 pharmacists. Independent community pharmacists are readily accessible medication experts who can help lower health care spending. They are committed to maximizing the appropriate use of lower-cost generic drugs and reducing the estimated $290 billion that is wasted annually by improper medication use. To learn more go to www.ncpanet.org or read NCPA's blog, The Dose, at http://ncpanet.wordpress.com.
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