By Jesse C. Dresser, Esq. and Jonathan E. Levitt, Esq.
Earlier this month, Oregon Governor John Kitzhaber signed H.B. 2123 into law, which provides for sweeping oversight of pharmacy benefits mangers (PBMs) in the Oregon. H.B. 2123 implements fair audit standards that apply when PBMs conduct audits of community pharmacies. For example, the law provides an 18-month look-back period for audits, and limits audits to no more than 200 claims at a time. In addition, the law prohibits a PBM from beginning to recoup monies from a pharmacy for discrepant claims until the audit and the appeals process is complete and final. These new requirements provide additional leverage to a pharmacy faced with an audit from a PBM.
In addition to the fair audit procedures, the law now requires PBMs to register with the State’s Insurance Division and increase transparency.
