2022年宾夕法尼亚医疗补助审计显示,由于人力服务部的透明度缺口,造成700万美元的不当"价格扩散". 2022 Pennsylvania Medicaid audit reveals $7M in improper "spread pricing" due to Department of Human Services transparency gap.
根据最近的一项审计，宾夕法尼亚州审计长蒂姆·德福尔 （Tim DeFoor） 报告称，2022 年该州的医疗补助计划存在 700 万美元的不当“价差定价”。 Pennsylvania's Auditor General Tim DeFoor reported $7 million in improper "spread pricing" in the state's Medicaid program in 2022, according to a recent audit. 报告声称,人力服务部允许这种透明度差距,导致向医疗补助方案支付的费用超过处方药所需的费用。 The report claims that the Department of Human Services (DHS) allowed this transparency gap, leading to paying more into the Medicaid program than necessary for prescription drugs. 差价是指药店福利管理员 (PBM) 为药店处方支付的报销和其向医疗保险公司收取的费用之间的差异. Spread pricing refers to the difference between reimbursements a pharmacy benefit manager (PBM) pays a pharmacy for a prescription and the cost it charges the health plan. DeFoor的报告建议为传输费、分散定价和自由通过定价增加更明确的定义,将其纳入国家法律。 DeFoor's report recommends adding clearer definitions for transmission fees, spread pricing, and pass-through pricing into state law.