* Pharmacy Audit Integrity House Bill 946 & Senate Bill 668
*Talking Point Sheet for Pharmacists, Pharmacy Technicians and Student Pharmacists ONLY (Not for Distribution)
House Bill (HB): 946 Bill Sponsor (House): Representative Matt Baker (R-Tioga)
House Co-Sponsors: Thank them for their support! Rep. Matt Baker Rep. Neal Goodman Rep. Scott Petri Rep. Steve Barrar Rep. Seth Grove Rep. Tina Pickett Rep. Mike Carroll Rep. Patrick Harkins Rep. Marguerite Quinn Rep. Mark Cohen Rep. Kristin Hill Rep. Harry Readshaw Rep. Dom Costa Rep. Mark Keller Rep. Steve Santarsiero Rep. Paul Costa Rep. Tom Killion Rep. Stan Saylor Rep. Angel Cruz Rep. Jerry Knowles Rep. Mike Schlossberg Rep. Mary Jo Daley Rep. Mark Longietti Rep. Craig Staats Rep. Tina Davis Rep. Robert Matzie Rep. Curtis Thomas Rep. Tony DeLuca Rep. Daniel McNeill Rep. Marcy Toepel Rep. Garth Everett Rep. Nick Miccarelli Rep. Judy Ward Rep. Flo Fabrizio Rep. Thomas Murt Rep. Katharine Watson Rep. Frank Farry Rep. Brandon Neuman Rep. Rosita Youngblood Rep. John Galloway Rep. Mike O’Brien Rep. Jaret Gibbons Rep. Eddie Day Pashinski
When discussing this bill, keep in mind the following:
1- Thank current co-sponsors of HB 946. If your Representative is not a co-sponsor, ask him or her to co- sponsor and support.
2- HB 946 was unanimously voted out of the House Health Committee in October 2015. HB 946 now awaits consideration by the full House of Representatives.
3- Ask your Representative to vote “yes” on HB 946 comes up for a vote before full House of Representatives for a vote.
4- Request that your Representative ask House Leadership to bring this bill up for a vote as soon as possible!
Senate Bill (SB): 668 Bill Sponsor (Senate): Senator Rich Alloway (R-Franklin)
Senate Co-Sponsors: Thank them for their support! Sen. Rich Alloway Sen. Tommy Tomlinson Sen. Ryan Aument Sen. Randy Vulakovich Sen. John Blake Sen. Don White Sen. Thomas McGarrigle Sen. Gene Yaw Sen. Bob Mensch Sen. John Yudichak Sen. Pat Stefano
When discussing this bill, keep in mind the following:
1- This bill has not been formally introduced; but the bill number has been reserved. The bill will be formally introduced once language has been finalized.
2- Thank current co-sponsors of SB 668. If your Senator is not a co-sponsor, ask him or her to co-sponsor and support.
2 - SB 668 (when formally introduced) will likely be referred to the Senate Banking and Insurance Committee. If your Senator is a member of the committee, request his or her support and ask that he or she ask Sen. Don White (R-Indiana) to bring the bill up for a vote when it is introduced.
3- If your Senator is not a member of the committee, ask for his or her support when SB 668 comes before the full Senate for a vote.
Senate Banking and Insurance Committee members:
Majority (Republicans) Minority (Democrats) Sen. Don White – Chair Sen. Sean Wiley- Chair Sen. John Eichelberger Sen. Jim Brewster Sen. Thomas McGarrigle Sen. Larry Farnese Sen. Guy Reschenthaler Sen. Christine Tartaglione Sen. Pat Vance Sen. Elder Vogel Sen. Kim Ward Sen. Gene Yaw
Ask Your Legislators to Vote “Yes” for this bill because:
In Pennsylvania, there are no oversight or procedural requirements in place for audits conducted on pharmacies.
Pharmacy audits are necessary to prevent fraud; but they should be performed in a fair manner and not designed to simply take back money. Nothing in these bills prevents the investigation and penalization of actual fraud!
Fair guidelines on pharmacy audits would be established—such as: written notice provided to the pharmacy prior to an onsite audit, clerical or recordkeeping errors such as a typo are not considered fraud and subject to recoupment or penalties, the time period covered by the audit shall not exceed a certain time period and auditing entity’s may not be paid based on a percentage of the amount recovered,
It also will protect pharmacies from auditing entities who use a statistical technique; in which they audit a small sample of claims and project their findings to a larger universe.
Pharmacies are currently having thousands of dollars reclaimed from them despite the right prescription being dispensed to the correct patient at the appropriate time.
Real-life Example: A prescriber wrote a prescription and made an error when writing the script. The prescriber crossed out the incorrect strength of a medication and wrote the correct strength. The pharmacy filled the prescription since it was obvious that the prescriber made a simple mistake. When the pharmacy was audited, they were cited for “quantity changed or altered” and forced to pay back the entire amount they were paid for the prescription—including all refills!
Thirty-four states have enacted some form of fair and uniform pharmacy audit laws.