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August 28, 2024 - Coraopolis, PA

Auditor General DeFoor: Lack of Oversight by DHS and Spread Pricing by PBMs Cost PA Taxpayers $7 Million in 2022

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 Ward
PA Auditor General DeFoor
Eddie DeCaria, Pharmacist
Representative Valerie Gaydos



Pennsylvania Auditor General Timothy L. DeFoor along with State Senator Judy Ward, State Representative Valerie Gaydos, and Pharmacist Eddie DeCaria announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_001.jpg" target="_blank">⇣ Download Photo</a> Pennsylvania Auditor General Timothy L. DeFoor along with State Senator Judy Ward, State Representative Valerie Gaydos, and Pharmacist Eddie DeCaria announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_002.jpg" target="_blank">⇣ Download Photo</a> Pennsylvania Auditor General Timothy L. DeFoor along with State Senator Judy Ward, State Representative Valerie Gaydos, and Pharmacist Eddie DeCaria announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_003.jpg" target="_blank">⇣ Download Photo</a> Pennsylvania Auditor General Timothy L. DeFoor along with State Senator Judy Ward, State Representative Valerie Gaydos, and Pharmacist Eddie DeCaria announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_004.jpg" target="_blank">⇣ Download Photo</a> Pennsylvania Auditor General Timothy L. DeFoor along with State Senator Judy Ward, State Representative Valerie Gaydos, and Pharmacist Eddie DeCaria announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_005.jpg" target="_blank">⇣ Download Photo</a> Pennsylvania Auditor General Timothy L. DeFoor along with State Senator Judy Ward, State Representative Valerie Gaydos, and Pharmacist Eddie DeCaria announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_006.jpg" target="_blank">⇣ Download Photo</a> Pennsylvania Auditor General Timothy L. DeFoor along with State Senator Judy Ward, State Representative Valerie Gaydos, and Pharmacist Eddie DeCaria announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_007.jpg" target="_blank">⇣ Download Photo</a> Pennsylvania Auditor General Timothy L. DeFoor  announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_008.jpg" target="_blank">⇣ Download Photo</a> Pennsylvania Auditor General Timothy L. DeFoor along with State Senator Judy Ward, State Representative Valerie Gaydos, and Pharmacist Eddie DeCaria announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_009.jpg" target="_blank">⇣ Download Photo</a> Pennsylvania Auditor General Timothy L. DeFoor along announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_010.jpg" target="_blank">⇣ Download Photo</a>  State Senator Judy Ward, State announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_011.jpg" target="_blank">⇣ Download Photo</a> Pennsylvania Auditor General Timothy L. DeFoor announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_012.jpg" target="_blank">⇣ Download Photo</a> Pennsylvania Auditor General Timothy L. DeFoor  announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_014.jpg" target="_blank">⇣ Download Photo</a> Pharmacist Eddie DeCaria announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_015.jpg" target="_blank">⇣ Download Photo</a>  Pharmacist Eddie DeCaria announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_016.jpg" target="_blank">⇣ Download Photo</a> Pharmacist Eddie DeCaria announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_017.jpg" target="_blank">⇣ Download Photo</a> Representative Valerie Gaydos  announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_018.jpg" target="_blank">⇣ Download Photo</a> Representative Valerie Gaydos announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_019.jpg" target="_blank">⇣ Download Photo</a> Pennsylvania Auditor General Timothy L. DeFoor along with State Representative Valerie Gaydos announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_020.jpg" target="_blank">⇣ Download Photo</a> Representative Valerie Gaydos announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_021.jpg" target="_blank">⇣ Download Photo</a> Pennsylvania Auditor General Timothy L. DeFoor along with State Senator Judy Ward, State Representative Valerie Gaydos, and Pharmacist Eddie DeCaria announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_022.jpg" target="_blank">⇣ Download Photo</a> Pennsylvania Auditor General Timothy L. DeFoor along with State Senator Judy Ward, State Representative Valerie Gaydos, and Pharmacist Eddie DeCaria announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_023.jpg" target="_blank">⇣ Download Photo</a> State Senator Judy Ward announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_024.jpg" target="_blank">⇣ Download Photo</a> Representative Valerie Gaydos announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_025.jpg" target="_blank">⇣ Download Photo</a> Pennsylvania Auditor General Timothy L. DeFoor along with State Senator Judy Ward, State Representative Valerie Gaydos, and Pharmacist Eddie DeCaria announced the findings of a performance audit of the Pennsylvania Department of Human Services' oversight of the Medicaid program and their monitoring of pharmacy benefit managers, also known as PBMs..<br><a href="https://filesource.amperwave.net/commonwealthofpa/photo/26416_audGen_pharmacy_JF_026.jpg" target="_blank">⇣ Download Photo</a>