Does a Pharmacy Benefit Manager (PBM) need to provide notice of an audit to a pharmacy?

In Minnesota, Pharmacy Benefit Managers (PBMs) are required to provide pharmacies with a notice of an audit at least 14 days prior to the audit. This requirement is intended to give pharmacies sufficient time to prepare for the audit, ensuring that they can gather the necessary documentation and information that the PBM may require to assess compliance and reimbursement. The 14-day notice period is a protective measure designed to enhance transparency and fairness in the auditing process between PBMs and pharmacies.

This requirement is part of broader regulations aimed at ensuring that the practices of PBMs do not create unfair burdens on pharmacies, especially independent ones. By mandating advance notice, the regulation helps pharmacies to properly organize their records and address any potential issues that may arise during the evaluation.

In contrast, other options either suggest shorter notice periods or imply that notice isn’t necessary, which would not adhere to the regulations established to protect pharmacies in their dealings with PBMs. Overall, the necessity of a 14-day notice before an audit reinforces the collaborative relationship intended between PBMs and pharmacy providers.