Here’s How Your Wholesaler Could Land You an Audit — Optum Users, We’re Looking at You
We’ll be the first to admit that the cards are stacked against pharmacy owners. Pharmacies are faced with fees, clawbacks and dwindling reimbursements at every turn. It’s no wonder many are trying creative methods to squeeze extra profit from any source they can find in order to avoid shrinking margins. Your PBM could make matters far worse. Optum users, we’re looking at you. Read on to find out more.
The creative method we’re referring to is the practice of choosing smaller wholesalers in order to save a few bucks. Generally, this makes sense. You pay less for a drug on the wholesale level to increase margins on the retail side. But this is a slippery slope, especially if your wholesaler is not compliant.
What Does Compliance Have to Do With Profit?
For pharmacies that contract with Optum, everything.
If you’re reading this blog, you probably know that Optum is one of the “Big Three” PBMs responsible for 80% of all insurance claims. Starting April 1, 2018, Optum is requiring all wholesalers and suppliers to be VAWD Certified and if they’re not, the pharmacy dispensing the drug can expect audits, clawbacks and possibly even loss of the contract.
This is why it’s so imperative that you do not unsuspectingly fall into this hole while you’re chasing a marginal increase. Is a 2% bump worth an audit or a loss of contract?
What is a VAWD Certification Anyways?
VAWD stands for Verified-Accredited Wholesale Distributor.
This credential is in addition to the standard operating procedures that are required to get licensed in each individual state. In the United States, each state has their own set of guidelines required to become a wholesaler. What is required by one state, may not be in another and can cause potential misfires when doing business across state lines. The VAWD certification is important because in some states, it is very easy to get a wholesale license and the standards for where the drugs can be sourced from is more relaxed.
VAWD ensures that not only is the wholesaler meeting the qualifications and standards of their home state, but they’re also meeting the qualifications of all 50 states, the FDA, and more.
While this certification is raising the drug chain standards, stopping gray market drugs and is safer for the patients, it does create an extra layer of headaches for pharmacy owners.
Find Out More in Our Crucial Latest eBook
In our latest eBook, the Pharmacy Wholesaler Buyer Beware Guide we’ll show you what those extra layers of headaches look like for owners and how to ensure you’re properly protecting your pharmacy.
In this FREE eBook, you’ll also learn…
- What it means to be VAWD certified
- How to identify wholesalers that could be harming your standing with Optum
- Why sourcing the cheapest drugs isn’t always worth the risk
- The 3 questions to ask your new and existing suppliers
- The impact reputable wholesalers can have on your bottom line and patients’ lives (We’re talking $3,000 in additional profits per week!)
Download the eBook now and save yourself or a fellow pharmacy owner from the dreaded clawback, audit or lost contract.
Launch Your Profitability the Right Way
Why make an extra 1–8% in profits and risk your Optum contract by saving pennies on a wholesaler, when you can earn thousands towards your bottom line by doing what the most successful pharmacies do?
Come see for yourself why we are so confident in our ability to change your life and improve the profitability of your pharmacy that we have a conference guarantee. If you don’t see the value of the PDS Super-Conference after the first day, we’ll reimburse your travel up to $500 and give you an additional $300 — no questions asked.
Still Not Convinced?
If attending a career-changing event is not for you at this time, you can join the discussion on topics just like this one, with other owners on PDSadvantage. It’s free to join and allows you to access the pharmacy owner forum and participate in these trending topics. Click here to create your free account on PDSadvantage,