Suffolk officials ask for prescription-plan audit

Suffolk officials who oversee the county's employee health plan have asked Comptroller Joseph Sawicki to conduct an audit to find out whether $17 million in expected prescription-plan savings will materialize by next year to avoid a new budget hole.

Sawicki said he agreed to audit the $70 million drug program, administered by Express Scripts Inc., as well as other parts of the county's self-insured health plan, after talks with the plan's co-chairs -- Jeffrey Tempera, representing management, and Noel DiGerolamo, Suffolk PBA president.

"They've expressed concerns to me over the savings that have yet to be realized," said Sawicki. "So we'll be looking at the areas where promises were made to the county, and if they don't materialize -- why." Most savings were expected to come from requiring employees to order long-term prescriptions by mail.


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The audit comes after legislative budget analysts disclosed late last month that the health plan's own consultants forecast in August that the county could need $29.8 million more than the $322.3 million County Executive Steve Bellone had in his 2014 budget for health insurance costs next year. The biggest part of the projected increase is $16.1 million more for prescription claims. Last week, the county legislature amended Bellone's budget to add $7.2 million to begin to close the potential gap.

In their report, legislative budget analysts estimated the budget had $25.5 million in shortfalls, some fixed by budget amendments and another $50 million in county fiscal policies that pose a potential risk of deficit.Deputy County Executive Jon Schneider said an audit is needed because the monthly number of prescriptions has recently risen by 10,000 to 90,000, even though the workforce has dropped by 1,000.

"No one can explain why we have a spike in prescriptions when we have fewer employees," he said.

Brian Henry, an Express Scripts spokesman, said the county has a right to audit the program under the contract, adding the company appreciates serving the county and looks forward to the continuing process for new proposals.

DiGerolamo said officials are asking for an immediate review because the county is weighing proposals from seven firms that want to administer the prescription plan starting in April 2014. The plan covers 20,000 county workers and retirees, as well as 28,000 dependents.

The problems come after the county in January picked a new company, Optum Rx, to run the program, which was expected to create a $17 million saving.

However, the county dropped San Diego-based Optum Rx just before it was to take over because of a contract dispute.

Instead, the county extended for one year its contract with St. Louis-based Express Scripts, the nation's largest drug administrator. Officials said the company promised to give Suffolk discounts it offered in its bid and make the savings retroactive.

DiGerolamo said Express Scripts never guaranteed a specific dollar savings, but the committee wants an audit to better assess pending proposals.

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