The Ohio Senate today passed Senate Bill 258, sponsored by Senator Troy Balderson (R–Zanesville), which establishes standards for the oversight of pharmacy audits in Ohio.
“My main objective in the Statehouse has been to create an environment in Ohio where businesses can grow and thrive so we can help our friends and neighbors get back to work,” said Balderson. “When our local pharmacies came and showed me the costly and burdensome process they have to undergo during audits, I knew we needed to do something to help these family-owned businesses.”
Ohio pharmacies are routinely audited by health plans and insurance companies to check for accuracy and to make certain there has been no fraud, waste, abuse, or clerical errors that may cause accidental overpayments. However, these audits frequently occur with little or no notice to the pharmacy and can be overly burdensome for local, independently owned pharmacies.
“This bill provides fair and uniform oversight for pharmacy audits and ensures this process pinpoints and weeds out actual fraud instead of simply creating unnecessary loopholes without improving the system for Ohioans or our local businesses,” added Balderson.
On average, the cost of per audit to a pharmacy is $2,500 and some Ohio pharmacies indicated that they face 6 of these audits each year.
Senate Bill 258 would make Pharmacy Benefit Managers (PBMs) subject to reasonable audit standards by placing guidelines on when and how audits are conducted. These new standards include:
29 other states have already enacted audit reform measures similar to those in Senate Bill 258. The legislation now proceeds to the Ohio House of Representatives for further consideration.
Senate President Keith Faber responds to calls for joint hearings on state's Ebola response.
In addition to serving as a Senator in the Ohio General Assembly, I have owned and operated a pharmacy in my hometown of Marysville, Ohio since 1997. As health care providers, one of the most important roles of pharmacists is to promote health and prevent disease within the community. With this in mind, I want to let you know that September is National Prostate Cancer Awareness Month.
September marks the beginning of a new school year, the start of football season and cooler weather, but more importantly, it’s Campus Fire Safety Month. Last month I introduced Senate Bill 359 which addresses the very real need for improved fire safety measures in off-campus and rental homes.