August 28, 2024 - Coraopolis, PA
Auditor General Timothy L. DeFoor released a performance audit that showed Pennsylvania taxpayers paid $7 million more for Medicaid prescription drug benefits than they should have during 2022 because of lack of oversight by the Department of Human Services and spread pricing by pharmacy benefit managers (PBMs)."Our auditors found evidence of spread pricing, inadequate monitoring by DHS and overcharging of taxpayers by PBMs, resulting in a loss of $7 million in taxpayer money in just 2022 alone," Auditor General DeFoor said. "PBMs are counting on the fact that no one is checking their reporting so they can get paid a higher rate and still collect a fee from the pharmacy. We made recommendations to ensure more accountability and process improvements, but what really needs to happen here are changes in the law."DHS contracts with managed care organizations (MCOs) to implement the Physical HealthChoices Medicaid program. MCOs then contract with PBMs to manage the prescription drug benefits for the program. According to DHS, more than 2.8 million Pennsylvanians utilize this taxpayer-funded benefit. List of Speakers:Senator Judy WardPA Auditor General DeFoorEddie DeCaria, PharmacistRepresentative Valerie Gaydos
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