My main issue with our pharmacy environment today (sorry, it's not clinical)!!

Why is it that pharmacy benefit managers (PBMs) can stack the deck in their favor and no one seems to see a problem with that. We have NO input in the the contract language and formation. We have NO input as to reimbursement for our services. We CANNOT provide 30 & 90 day Rxs at the same co-pay or rates as mail order (PARDON ME !, "home delivery"). We CANNOT force our customers to use our pharmacies while the PBMs threaten customers with their mail order or pay full price. We CANNOT call the PBMs mail order customers and offer them "free co-pays" (Humana Part D) if they will switch to me!! We CANNOT audit the PBMs, even though several of them have gotten their hand caught in the cookie jar and have stolen millions of dollars. We would NOT be able to continue doing business if we committed the FRAUD, WASTE, & ABUSE that these outfits are committing daily. Why is it we were FORCED to comply with accreditation with Medicare when we had such a low ratio of Medicare dollars paid vs. our everyday business? Why is it that insurance companies are selling FSA, HSA, XYZ policies and then basically force us to buy expensive POS systems and upgrade software and hardware in order to run the very few cards we get, then having to explain why they can't buy ibuprofen but they can get Tylenol on their cards. And WHY are we always the ones stuck with paying fees for all this wonderful technology? We went from $0.00 to ~ $450-500 per month on credit card fees which we never accepted until the FSA, HSA, XYZ thing started.More »