Texas Senate Bill SB692

Texas 2019 - 86th Regular

Caption

Relating to the audit of wholesale invoices during certain audits of pharmacists and pharmacies.

Impact

The implementation of SB692 is likely to result in changes to state laws governing pharmacy audits. By limiting the scope of audits and establishing specific requirements for evidence related to pharmacy claims, the bill seeks to protect pharmacists from undue penalization based on discrepancies tied to wholesale invoices. Such changes may lead to a more transparent auditing process, which can help ensure that pharmacists are treated fairly and that their claims are validated without excessive scrutiny of unrelated audits.

Summary

Senate Bill 692 (SB692) addresses the auditing process for pharmacists and pharmacies, particularly concerning the evaluation of wholesale invoices during audits performed by health benefit plan issuers or pharmacy benefit managers. The bill specifies that an audit cannot simultaneously assess the pharmacy claims of another health benefit plan or pharmacy benefit manager. This provision aims to streamline audits and avoid conflicts of interest in the auditing process, thus providing clearer guidelines for pharmacies amidst ongoing audits.

Contention

While the bill appears to provide advantages for pharmacies, potential points of contention might arise from health benefit plan issuers or pharmacy benefit managers, who may view the limitations imposed by SB692 as hindrances to their auditing capabilities. Critics could argue that the legislation might permit lax oversight of pharmacy billing practices, potentially opening avenues for fraudulent claims. These concerns underscore the delicate balance between protecting pharmacies' rights and maintaining rigorous standards for auditing practices.