Are PBM’s keeping monies recouped from audits?

This is a press release from NCPA (National Community Pharmacist Association)

While Part D pharmacy audits are necessary to detect fraud and abuse, PBMs are abusing this process by singling out expensive drugs and targeting typographical errors in order to recoup significant amounts of money that are in turn not turned over to the Medicare program. Also, pharmacies are typically forced to sign contracts with Part D plans and/or PBMs without any disclosure of the terms and conditions surrounding reimbursement for generic drugs. Increasingly, pharmacies are being paid below their costs to dispense and the Maximum Allowable Cost (MAC) lists are not updated on a regular basis in order to reflect generic drug spikes.

If this is true… is the entities that are suppose to be detecting fraud and abuse within the Medicare Part D program..  defrauding the taxpayers… by keeping the money that they have recouped?

If this is true.. who lobbied who and what money passed hands when this part of the Part D bill was passed or regulations were written?

And what community pharmacy corporation is a major provider of Part D insurance ?  Is being able to audit your competitors and keeping what money you recoup.. a MAJOR conflict of interest ?

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