HARRISBURG (AP) – An audit says there are shortcomings in a state agency’s oversight of fees paid to pharmacy benefit managers in the Medicaid program. But the claims in the report issued by PA Auditor General Timothy DeFoor are disputed by state officials. The report says the Department of Human Services allowed $7 million in improper “spread pricing” in the Medicaid program in 2022. Agency officials say the money paid by pharmacies to pharmacy benefit managers did not constitute spread pricing which was banned for Medicaid in PA four years ago. They say that money is “transmission fees” that have been allowed, but are being eliminated next year. DeFoor said the “transmission fee” is spread pricing, adding that the main issue was what he considered to be a lack of transparency. The end result, he said, is that Human Services “is paying more into Medicaid than it should for prescription drugs.” You can read the audit by clicking on the photo below.
