Auditor faults Pennsylvania agency over fees from Medicaid-funded prescriptions

Associated Press

HARRISBURG, Pa. (AP) — A review by Pennsylvania’s elected financial watchdog 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 a report issued Wednesday by Auditor General Tim DeFoor are hotly 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. But agency officials say the money paid by pharmacies to pharmacy benefit managers didn’t constitute spread pricing — which was banned for Medicaid in Pennsylvania four years ago. They say that money is “transmission fees” that have been allowed but are being eliminated next year.