PBM Audit Myers and Stauffer

The Florida Agency for Health Care Administration (AHCA) Master Agreement MED220 is an Indefinite Delivery Vehicle focused on comprehensive pharmacy benefit manager (PBM) investigative audit services for the Statewide Medicaid Managed Care (SMMC) program. The contract enables detailed investigations into the organizational structures, contractual arrangements, and payment terms of PBMs within Florida's Medicaid managed care health plans. Specific services include developing quarterly and annual pharmacy claims reconciliation report templates, analyzing pharmacy claims reports submitted by SMMC health plans, validating expenditure data, monitoring compliance with contract terms, and providing comprehensive investigative reports covering calendar years 2016-2018.

The master agreement is awarded to Myers and Stauffer LC, a professional services firm, with an initial contract value of $1,029,135.00. The contract was originally established on August 31, 2022, with subsequent amendments extending the performance period through August 31, 2026. The IDV covers the state of Florida and is structured as a Master Agreement contract type. Through multiple amendments, the contract value has increased to $2,165,372.00, with quarterly deliverables ranging from approximately $83,000 to $88,000 per report. The contract includes performance bond requirements and specific performance standards, ensuring rigorous oversight and accountability in the investigation of Medicaid pharmacy benefit administration.