House Committee Investigates PBMs Over Alleged Retaliatory Pharmacy Audits
The House Committee on Oversight and Government Reform launched an investigation Oct. 23 into pharmacy benefit managers Optum Rx, CVS Caremark and Express Scripts, examining whether independent pharmacies were targeted with punitive audits for publicly supporting HR 6610. Chairman James Comer said audit notices increased after a July committee markup of the bill, which would require PBMs serving Federal Employees Health Benefits Program plans to pay pharmacies a capped benchmark price and a dispensing fee tied to state Medicaid rates. The committee cited one audit over a $0.99 medication that consumed hundreds of staff hours at an independent pharmacy. CVS said it will respond to the committee's letter; Optum Rx declined comment and Express Scripts has not yet responded.