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Ohio ends moratorium on PBM audits

Ohio Department of InsuranceAs mentioned months ago, as the COVID-19 outbreak began rattling the foundation of our daily lives, OPA had received several reports from pharmacists that insurers and PBMs had continued to conduct audits on prescription records at pharmacies amidst their efforts to scramble to provide necessary care during the unprecedented pandemic.

Amidst this period of immense risk and disruption, we believed these audits had no place, and they unnecessarily wastes precious time and resources.

After OPA submitted several requests to Governor Mike DeWine to help pharmacists raise the standard of care and keep patients safe during the emergency pandemic, included in our requests to the state was a request for the state to put a moratorium on these PBM audits and postpone them until after the high points of the pandemic had passed.

We were thankful when the administration announced their agreement with the request, as the Ohio Department of Insurance ODI pulled the plug on PBM audits on March 20, 2020. Now that the peak risk period of the crisis is hopefully behind us, ODI recently reached out to us to let us know of their intent to end the suspension. ODI had staff had early, proactive discussions about the lifting of the order, and we very helpful, understanding, and communicative throughout the process, and with that, on June 25, the formally rescinded the order. 

We would like to thank Governor DeWine and Ohio Department of Insurance Director Jillian Froment for suspending all PBM audits in Ohio at a time we felt it was essential to keep pharmacists focused on infection control, adapting their practices, and keeping patients safe. And we'd like to thanks their team at ODI for their spirit of collaboration with the pharmacy community.

To visit OPA's COVID-19 resource page, click here.

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