PBMs Enforcing Return to Stock Policies
It is common practice for PBMs to recoup claims [in full] for medications being picked up after the return to stock timeframes listed in their provider manuals (also known as “unclaimed prescriptions”). Pharmacies with an integrated Point-of-Sale should look to generate a list of prescriptions near the allowed timespan for medications to be left in pick-up bins. PAAS recommends pharmacies implement a procedure to only allow medications to remain for the shortest outlined time – 10 days. If your pharmacy has PAAS National®’s Fraud, Waste & Abuse program, a return to stock policy is available to you, including a log to help you document & complete this task (see section 4.1.1 Unclaimed Prescriptions and Appendix B – Unclaimed Prescription Reversal Log).
Major PBM Return to Stock Timeframes:
Become an audit assistance member today to continue reading this article. As a member, you’ll have access to hundreds of articles and receive our monthly proactive newsletter!
- Aetna: 14 days
- Caremark: 14 days
- Humana: 15 business days
- Prime Therapeutics: 14 days
- Serve You Rx: 10 days
- Southern Scripts: 10 business days
- MagellanRx: 14 days
- MedImpact: 14 days
- MeridianRx: 10 days
- OptumRx: 14 days
- EnvisionRx: 14 days
- Express Scripts: 13 days
I obtained my PharmD from the University of Wisconsin-Madison School of Pharmacy and worked for a major chain as well as various LTC and independent pharmacies, before coming to PAAS.
I am passionate about learning and teaching. I strive to learn something new about PBM audits every day, so that PAAS can be more knowledgeable to better serve our members! In 2018, I started traveling to state pharmacy conferences to present audit seminars and meet our wonderful members in person.
- Caremark Notice of Breach – Aberrant Practices and Trends - April 20, 2024
- Caremark Invoice Audits – Purchases from Other Pharmacies - April 10, 2024
- Qualified Medicare Beneficiary (QMB) Program - April 2, 2024
