Home Industries Health Services Prime Therapeutics to terminate audits on 3 independent pharmacies in AG agreement

Prime Therapeutics to terminate audits on 3 independent pharmacies in AG agreement

By

Jacquelyn Voghel

-

02/04/2026

Prime Therapeutics LLC — PRIME THERAPEUTICS LLC will terminate audits on three independent Rhode Island pharmacies after the R.I. Attorney General's Office alleged that the pharmacy intermediary violated state legislation.

PROVIDENCE – Pharmacy benefit manager Prime Therapeutics LLC will terminate audits on three independent pharmacies and enact future compliance measures under an agreement reached with R.I. Attorney General Peter F. Neronha. Neronha’s office alleged that on Oct. 27, 2025, Prime Therapeutics, a subsidiary of Blue Cross Blue Shield Association, initiated unannounced audits against three independent

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PROVIDENCE – Pharmacy benefit manager Prime Therapeutics LLC will terminate audits on three independent pharmacies and enact future compliance measures under an agreement reached with R.I. Attorney General Peter F. Neronha. Neronha's office alleged that on Oct. 27, 2025, Prime Therapeutics, a subsidiary of Blue Cross Blue Shield Association, initiated unannounced audits against three independent Rhode Island pharmacies, violating the state's Pharmacy Audit Act. The legislation limits pharmacy benefit managers, insurance carriers and other pharmacy intermediaries to one audit per year unless fraud is suspected and requires them to provide a 14-day notice for audits. It also bars auditors from receiving pay from recouped money and extrapolating audit findings. In addition to not providing adequate notice, Neronha detailed in court documents that Prime Therapeutics audited the pharmacies for a period longer than two years and did not allow them to reschedule the audits. “Where there’s money to be made, there will inevitably be those willing to exploit an industry to maximize profit, and unfortunately, health care is not exempt,” Neronha said in a statement, noting that the office last year filed complaints against three of the country's largest pharmacy benefit managers: CVS Caremark, Express Scripts and Optum. Pharmacy benefit managers sometimes own or partner with pharmacies that compete with smaller, independent pharmacies, Neronha's office noted in its announcement, which incentivizes the intermediaries to target these local businesses. "We allege that these groups often exploit the complex scheme of pricing and payment for prescription drugs, and take a cut of ever-increasing drug prices at every step of the way," Neronha wrote. Prime Therapeutic's actions "caused undue administrative burden and disruption to three independent Rhode Island pharmacies by showing up unannounced and demanding to see their books," Neronha continued. "This kind of behavior can drive up pharmacy costs, limit care choices, and harm local businesses if left unchecked." Under the agreement, Prime Therapeutics must follow additional compliance measures such as producing memorandums that detail the basis for audits. Jacquelyn Voghel is a PBN staff writer. You may reach her at Voghel@PBN.com.