Pharmacy Audits and Inspections – Be Prepared!

Pharmacy Audits and Inspections:

Pharmacy inspections and audits are a fact of life for every pharmacy. It is a safe assumption that your pharmacy will be audited at a minimum of every two years. In today’s world of computerization and Social Media, a bad outcome that is documented publicly can literally cost you tens of thousands of dollars. The bad publicity that we have seen many pharmacies experience can lead to lost patients and revenue that could have been avoided. The key to avoiding a bad inspection or audit? Be prepared!

Every licensed pharmacy is inspected by their Board of Pharmacy every year or two. Yet many pharmacies are still caught off guard and aren’t prepared or in compliance resulting in an unfavorable (and expensive!) outcome. More problematic are unanticipated regulatory state or DEA inspections. Add in the unexpected audits by a Pharmacy Benefits Manager (PBM) and it is no wonder that many pharmacy owners tell us that they have trouble sleeping at night! How does a pharmacy prepare for all this? The answer is HCC!

Pharmacy compliance audits assess a pharmacy’s level of compliance in regards to procedures stipulated by regulatory or contractual arrangements. Basically pharmacy compliance audits can be placed into two categories:

  1. Third Party Provider Audits – Every pharmacy that is a contract provider of prescription services is subject to a clause in its provider agreement that allows an audit of the pharmacy’s records, including hard-copy prescriptions, signature logs, computerized records of refills, and invoice records.
  2. Regulatory Agency Audits – Pharmacies obviously are subject to audits conducted by state or federal licensing agencies such as the DEA and State Board of Pharmacy.

HCC’s regulatory experts can perform mock inspections and identify areas of weakness and concern. Our consultants will, upon completion of the inspection, prepare a Gap Analysis and corrective recommendations and discuss these with you and your team. If significant issues are found, our consultants are available to assist in the implementation of the corrective actions and perform a re-inspection to confirm compliance.

Our experts are also available to review your prescription filling and billing processes to identify areas that may put you at risk of a payer audit and recoupment demands. HCC’s consultants will work with you and your team to correct areas of concern and develop risk mitigation strategies to prepare your pharmacy for the unexpected, but inevitable, audit.

Don’t wait until you get the audit notice or find the state inspector at your counter! Call HCC and be ready. With over 25 years of experience in dealing with pharmacy inspections and audits, let HCC help you be prepared. Eventually your pharmacy will be the subject of a pharmacy audit. Don’t let an audit notification be a crisis situation and threat to your pharmacy business. As the old cliché says: An ounce of prevention is worth a pound of cure. Contact us on line or call us today for a Free Consultation at 800-642-1652 to discuss how we can help.


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