
Independent #pharmacist and TPA Board Member @DrBenMcNabb testified this afternoon before the Texas Senate Health and Human Services Committee about potential waste and abuse by pharmacy benefit managers (PBMs) in Texas Medicaid. McNabb shared how a PBM reported to HHSC a payment of $148.50 to his #pharmacy for tolterodine, but after clawbacks he only received about $30. “If you’re relying on the PBM data to detect fraud, waste, and abuse, I don’t think you’re going to find it,” McNabb said. “The numbers are fundamentally distorted. They’ve set up a system that creates an obfuscation of the true cost of the drug. The payments can be overstated, and accountability becomes nearly impossible. That is the definition of waste, and when it’s done knowingly, through reporting mechanisms, it raises serious concerns about abuse.” Committee Chair @LoisKolkhorst provided reassuring comments about vertical integration among PBMs. “We’ve been trying to get after this for quite some time,” she said. “We’re going to be really successful this next session.” #PBMReform





















