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Legislative auditors to resume PBM data review, aim to deliver spring report
Summary
Legislative auditors told the Senate committee they began PBM work in 2019, coordinated with the Insurance Department and awaited an external consultant's report; they expect to resume detailed data analysis and produce a report in the spring.
Legislative auditors updated the committee on the status of a planned PBM audit covering public funds (Medicaid fee‑for‑service, Arkansas Works, managed care pass systems and the state employee plan).
Roger Norman, legislative auditor, said the legislative audit office began PBM work in 2019 and coordinated with the Insurance Department, which engaged an outside consultant whose findings were released earlier in the year. Because of that work and other timing issues the auditors delayed data analysis and now expect to resume deeper data work after completing other audit obligations; they indicated a draft/informational report could be available in the spring.
Norman said auditors plan to examine spread pricing, claim‑level reconciliations and other contract terms in the public programs that auditors review. He told the committee the Supreme Court resolution of a related case may be a “ripple effect” that allows states to exercise regulatory authority more clearly, but added that the audit’s data work is the essential next step to confirm the extent of problematic practices and quantify potential savings.
The committee thanked the audit team and adjourned.
