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: 

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  • 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
Eric Hartkopf, PharmD