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HMS Acquires Prudent Rx to
Enhance Pharmacy Audit Capabilities.

In September HMS acquired the business of Prudent Rx, Inc., an independent pharmacy audit and prescription management organization based in California. This acquisition further expands our program integrity capabilities and service offerings for state Medicaid agencies and managed care organizations, particularly in the pharmacy arena.

Prudent Rx’s key products and services include audit programs, program design and benefit management, as well as general and pharmacy systems consulting. The company fields a team of recognized industry leaders with in-depth experience in the prescription benefit management industry. They have a team of desktop
and field auditors on staff in their Culver City offices.

Prior to founding Prudent Rx in 1994, Russell Dates and Laureen Waterman were part of the management team at a pharmacy benefit management (PBM) company called Prescription Health Services (PHS), which at the time was the largest privately held PBM in the U.S.; PHS was subsequently acquired by Caremark.

Later, when Russell and Laureen founded Prudent, they brought with them a core of PHS employees. Those employees are still with Prudent and give the company an unusually deep pharmacy industry knowledge foundation.

Auditing pharmacies and pharmacy claims is a critical component of any healthcare program, and often the only way to identify potential pharmacy fraud, billing errors, and abuse by patients and physicians. Prudent Rx offers expert management and consulting services based on its extensive industry knowledge, experience, and a proven track record of helping Medicaid agencies, managed care organizations, and other pharmacy benefit providers.

Adding Prudent Rx to the team is also another big step forward in HMS’s strategy to bring the entire range of program integrity services to the market through a single source. Prudent helps round out HMS’s position as an independent auditor of pharmacies and PBMs.