Sample Projects

The following are successful solutions....

  • PBM Audit Services and PBM Rebate Audit Services

  • A self-insured health plan retained IPS to conduct and audit on the pharmacy claims processed by their PBM. The audit reviews up to date pricing, accurate dispensing fees, application of co-payment, compound prescription pricing, and other criteria. IPS evaluated the claims and reported all discrepancies as well as made recommendations for reclaim.
  • A pharmacy data management firm contacted IPS to conduct an audit on manufacturer’s rebates on behalf of a client. IPS identified inconsistencies in rebate payment practices in our audit findings and provided recommendations for reclaim.
  • We have audited pharmacies, PBM’s, hospitals, and health plans for self insured clients.

  • Drug Utilization Review Oversight and Management

  • IPS worked with a state’s Medicaid administrator to run the Drug Utilization Review (DUR) program. This includes managing a staff of pharmacists who provided DUR for prior authorization-required medications, running monthly DUR committee meetings, analyzing utilization data to identify potentially overprescribed or inappropriately-prescribed medications and providing physician profile reports.

  • Monitoring Regulatory and Governmental Affairs

  • A number of national pharmaceutical companies retained IPS to monitor legislative and administrative issues of interest to that company. IPS prepared written summaries of those issues, provided advice as requested, assisted in the review of testimony, tracked the progress of various initiatives, collected information from government agencies and interest groups and appeared before legislative and administrative bodies on behalf of that company.

  • Pharmacy Regulatory Audits

  • After a reported controlled substance loss, a hospital contacted IPS to perform routine site inspections, audits and review of all aspects of pharmacy services related to controlled substance management, delivery, administration, record keeping and disposition.

  • Design of Pharmacy Services

  • In an effort to streamline pharmacy services for a distributed correctional system, IPS evaluated the needs of each facility, met with all key personnel, analyzed current resources, reviews budget consideration and then designed a centralized pharmacy services program. The centralized program was implemented and is still adding facilities for its services.

  • Expert Pharmacy Consulting

  • A law firm retained IPS on behalf of their client who was seeking regulatory relief from a Board of Registration in Pharmacy (BRP) to allow the client to continue using their current dispensing procedure. IPS reviews the procedure and provided an assessment report regarding compliance with applicable state laws and regulations. In addition, IPS drafted a waiver for the BRP, attended the meetings with the client, and assisted in the efforts geared toward a legislative solution to the issue.