The Ohio Senate today passed Senate Bill 258, sponsored by Senator Troy Balderson (R–Zanesville), which establishes standards for the oversight of pharmacy audits in Ohio.
“My main objective in the Statehouse has been to create an environment in Ohio where businesses can grow and thrive so we can help our friends and neighbors get back to work,” said Balderson. “When our local pharmacies came and showed me the costly and burdensome process they have to undergo during audits, I knew we needed to do something to help these family-owned businesses.”
Ohio pharmacies are routinely audited by health plans and insurance companies to check for accuracy and to make certain there has been no fraud, waste, abuse, or clerical errors that may cause accidental overpayments. However, these audits frequently occur with little or no notice to the pharmacy and can be overly burdensome for local, independently owned pharmacies.
“This bill provides fair and uniform oversight for pharmacy audits and ensures this process pinpoints and weeds out actual fraud instead of simply creating unnecessary loopholes without improving the system for Ohioans or our local businesses,” added Balderson.
On average, the cost of per audit to a pharmacy is $2,500 and some Ohio pharmacies indicated that they face 6 of these audits each year.
Senate Bill 258 would make Pharmacy Benefit Managers (PBMs) subject to reasonable audit standards by placing guidelines on when and how audits are conducted. These new standards include:
29 other states have already enacted audit reform measures similar to those in Senate Bill 258. The legislation now proceeds to the Ohio House of Representatives for further consideration.
"Our future is about innovating. It’s about improving. It’s about transforming. Ohio is becoming a premier state for entrepreneurs to start and expand their businesses. We must continue to build on this momentum by pursuing further improvements to our state's business climate," said Obhof.
“Steve has a tremendous record of leadership in the private sector,” said Obhof. “This was a very talented group of candidates, and every applicant for this seat made a strong impression on the committee. Steve offers a unique depth of experience, temperament and understanding of the issues impacting this region of the state, and we’re confident his constituents will agree. Our caucus looks forward to helping him serve the people of the 7th Senate district."
“The results highlighted in the report show that the collaborative approach taken by the legislature and executive branch, as well as the health care industry's concerted efforts to improve efficiency have been successful,” said Burke.
“Scott’s one of the most respected members of the Ohio Senate, and he offers an incredible wealth of experience and institutional knowledge to the budget process,” said Obhof. “He’s done a remarkable job guiding our chamber through the development of one of the most complex pieces of legislation we’ll consider throughout this General Assembly. I look forward to relying on his steady leadership and sharp insights in what appears to be a challenging fiscal environment ahead."