Community Forum : New Practitioner Network
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 Subject : PBM Clawbacks/MAC Issues.. 02/06/2018 09:59:36 AM 
J Cody Sandusky
Posts: 3
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Hello all! This is geared more towards our independent (maybe retail?). Since the beginning of January we have seen a *remarkably* higher level of PBM takebacks and MAC issues. We have an increasingly large stack of claims here to appeal. Just curious if others are seeing the same thing, and to what degree they're seeing it.
 Subject : Re:PBM Clawbacks/MAC Issues.. 02/06/2018 04:11:39 PM 
Todd M Evers
Posts: 3
Location
It has been terrible!!

What kind of system do we have that we have to transmit payment requests to our biggest competitor and they determine what are reimbursements are? Then they turn around and not only use this data against us with payers but also the money that they steal from us is used to buy us out at lower valuations!
Something must be done. If you have a chance watch the Arkansas Pharmacy hearing https://www.facebook.com/arpharmacists/videos/vb.118544928198009/1864599663592518/?type=2&theater
 
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