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IL licensing attorneyIf you have received notice of an upcoming pharmacy benefit managers (PBM) audit, there are several things you can do to prepare. The consequences of a PBM audit are real and can be long-lasting. Going into an audit prepared is advisable.

Many clients find that adequate preparation can alleviate problems that can come up during an audit. A skilled PBM audit defense attorney can identify specific areas that you should focus on in the time before your pharmacy’s audit. However, typically you will benefit from taking the following steps:

  • Review the written on-site audit notification. You want to pay close attention to the scope of the audit, including the date ranges that the audit will cover. The terms of the audit as stated in the letter should comply with your contract and will applicable laws. An attorney may be needed to determine compliance.
  • Check the date of the proposed audit. This date should be a date when you and other needed personnel will be present. An audit should not be left to employees to handle.
  • Create an audit file. This file or box should contain all correspondence, records, notes, and documentation of telephone calls related to the audit.
  • Meet with your staff. Your staff should be prepared for the audit as well.
  • Organize your records and conduct a self-audit. You should review what records you have as well as identify any problem areas that the PBM auditor may spot.
  • Prepare a designated physical area for the audit. This area should be private. It should also be away from your employees’ spaces and pharmacy operations. Often a closed-off breakroom with a table and chair is suitable.

Contact an Illinois PBM Audit Attorney

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Posted on in Pharmacy License Defense

Illinois license lawyerThe process to become a licensed pharmacist takes much time and effort, and to own a pharmacy comes with more expectations and requirements. If you own a pharmacy, you may expect to have pharmacy compliance audits run from time to time. There are many factors in pharmacy audits that you need to know in order to meet guidelines to keep the pharmacy intact.

Definition of Pharmacy Audit

A pharmacy audit is a formal review of operations and processes to make sure that pharmacies are compliant with pharmacy regulations and other related agreements. The pharmacy audit process can come in many different types, including desktop, onsite, prepay claims review, and investigational pharmacy audits.

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Illinois pharmacy audit defense attorneyPharmacies undergo both random and routine audits to ensure they are meeting the needs and best interest of consumers. Safety, cost management, and compliance are all issues that are examined during these inspections. Pharmacy audits may also search for any evidence of drug diversion among staff members. Learn how to protect yourself and your pharmacy from consequences of a poorly completed audit with help from the following information.

Advance Preparation for Routine Audits

Routine audits typically occur around the same time each year. Because of this, pharmacists and personnel have time to prepare. It is highly suggested that pharmacies do this with an experienced attorney who can conduct a review of the contracts, policy manuals, agreements, and other documents. An attorney can also review the pharmacy’s day-to-day operations to search for any compliance issues that need to be addressed. Lastly, an attorney can ensure you understand the audit process so that you and your staff know what to expect.

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Illinois State Bar Association DuPage County Bar Association Illinois Pharmacists Association American Pharmacists Association 10.0Joseph John Bogdan
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