Pharmacy Services
Pharmacy services are among the most complex and financially significant components of Medicaid, Medicare, and other government-sponsored health programs, requiring specialized expertise in reimbursement, pricing, compliance, and financial oversight. Myers & Stauffer partners exclusively with federal, state, and local government agencies to strengthen pharmacy program oversight, providing expertise in pharmacy reimbursement and rate setting, pharmacy benefit manager (PBM) oversight, Medicaid drug rebate program administration, NADAC, actual acquisition cost (AAC), state maximum allowable cost (SMAC), 340B compliance, Medicare Part C and Part D, pharmacy program integrity, and pharmacy data analytics. Our integrated financial, clinical, and operational approach helps agencies improve transparency, ensure regulatory compliance, optimize pharmacy reimbursement, and safeguard public resources.
Supporting Pharmacy Program Oversight, Reimbursement, and Financial Integrity
Pharmacy benefits represent one of the largest and most complex areas of spending across Medicaid, Medicare, and other government-sponsored health programs. Agencies must balance access to medications, regulatory compliance, reimbursement accuracy, and financial accountability while navigating rapidly evolving pharmacy markets and federal requirements.
Myers and Stauffer provides specialized pharmacy consulting, auditing, reimbursement, and oversight services exclusively to government agencies. Our team combines deep expertise in pharmacy pricing, reimbursement methodologies, PBM oversight, drug rebate programs, program integrity, and data analytics to help agencies strengthen pharmacy program performance and accountability.
Pharmacy Services Expertise
Our pharmacy services support government agencies across multiple pharmacy program functions, including:
Our work helps agencies ensure pharmacy programs operate efficiently, comply with federal requirements, and support appropriate stewardship of public funds.
Core Pharmacy Services
Myers and Stauffer provides specialized pharmacy consulting, reimbursement, auditing, and oversight services exclusively for government agencies. Our pharmacy expertise spans Medicaid, Medicare, state employee health plans, and other government-sponsored health programs.
Our services are organized around three core areas that support pharmacy program accountability, financing, and operational effectiveness.
Accurate reimbursement methodologies are essential to maintaining pharmacy access while ensuring responsible stewardship of public funds.
We help agencies design, evaluate, and maintain pharmacy reimbursement approaches, including actual acquisition cost (AAC) programs, state maximum allowable cost (SMAC) methodologies, National Average Drug Acquisition Cost (NADAC)-based reimbursement, cost of dispensing (COD) surveys, Medicaid managed care reimbursement oversight, and 340B reimbursement strategies.
PBMs play a critical role in administering pharmacy benefits across government-sponsored health programs. Effective oversight is essential to ensuring transparency, contract compliance, pricing accuracy, and financial accountability.
We provide independent PBM auditing, contract compliance reviews, pricing transparency assessments, claims validation, rebate oversight, and performance evaluations for Medicaid, Medicare, state employee health plans, and insurance regulatory agencies.
Drug rebate programs are a critical component of pharmacy program financing. Effective oversight helps agencies maximize available funding while ensuring compliance and financial accuracy.
We support Medicaid and Medicare pharmacy programs through rebate reconciliation, financial validation, manufacturer rebate oversight, Preferred Drug List (PDL) evaluations, managed care rebate reviews, and pharmacy financing analyses.
Effective pharmacy oversight requires sophisticated data analysis and targeted review activities.
Our team supports agencies through pharmacy claims analytics, utilization reviews, specialty drug monitoring, pharmacy billing audits, and fraud, waste, and abuse identification activities. These services help agencies identify risks, improve program performance, and strengthen accountability across pharmacy programs.
Many of these activities are performed in conjunction with our Program Integrity, PBM Oversight, and Drug Rebate services.
Why Agencies Hire Myers & Stauffer
Our pharmacy expertise spans multiple government-sponsored health care programs, including:
We understand the unique regulatory, operational, and financial considerations that affect pharmacy programs across each environment.
Myers and Stauffer works exclusively with federal, state, and local government agencies. We do not provide services to PBMs, health plans, pharmacies, pharmaceutical manufacturers, or providers, allowing us to maintain complete independence in our oversight activities.
Our pharmacy services are supported by:
We help government agencies strengthen pharmacy program oversight, improve reimbursement methodologies, enhance financial accountability, and ensure compliance across Medicaid, Medicare, and other government-sponsored health programs.
Whether evaluating PBM performance, designing reimbursement methodologies, or strengthening pharmacy program integrity, our focus is on helping agencies achieve transparent, defensible, and sustainable pharmacy program outcomes.
Connect With Our Team
Partner with experts who understand the complexities of health and human services programs. Let us guide your organization through the industry’s unique challenges and opportunities.
Bobby Courtney, MA, MPH, JD
Principal
Email: bcourtney@mslc.com
Phone Number: 317-815-5475
Jenna Hall, CPA, CFE
Member
Email: jhall@mslc.com
Phone Number: 919-829-7430
Allan Hansen
Principal
Email: ahansen@mslc.com
Phone Number: 816-957-6230
Andy Ranck, CPA
Member
Email: aranck@mslc.com
Phone Number: 410-581-4555
In the Words of our Clients…
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