Drug Topics Quotes Satish Poondi on the Increase of Third-Party Pharmacy Audits and What this Means for Pharmacies

September 7, 2023

Satish Poondi, co-chair of the firm’s Health Law & Pharmacy Law practice, was featured in an article published by Drug Topics, offering his take on the increase in pharmacy audits being conducted not only by pharmacy benefit managers (PBMs), but also by government agencies like Medicare and Medicaid.

As the article explains, while COVID caused the numbers of audits to temporarily decrease, PBMs and government agencies have now ramped up the number of audits being conducted. “Unfortunately, pharmacies are a low hanging fruit, due to the complex framework of regulations and contractual requirements inherent in the practice, and the audit process ends up generating revenue for these entities,” Poondi said. “Additionally, during the height of COVID-19, there was a decrease in audits and now we are seeing a more aggressive push by both PBMs and other payors.”

Poondi also discussed the repercussions of a “bad” audit, noting, “Those invested in multiple stores may also have to deal with termination of their other pharmacies due to contractual language relating to common ownership or control. Some PBMs have also penalized pharmacists, in their individual capacity, by denying contracts to other pharmacies that later employ the pharmacist.”

Poondi represents healthcare professionals and healthcare entities before licensing boards, including the New Jersey Board of Pharmacy, New Jersey Medicaid, Medicare, Drug Enforcement Administration, FDA, and the Office for Civil Rights.

Read “Rise of Third-Party Pharmacy Audits” here.