The purpose of a PBM audit is to ensure that a pharmacy has not misbilled the insurance company or committed other violations of state or federal law. If auditors discover violations, NGS has a variety of tools at its disposal. Most often, NGS will simply demand a recoupment, meaning the company will withhold money that would otherwise be payable to the pharmacy. However, NGS may also seek to terminate the contract with the pharmacy if the violations are serious. Given the relationship between NGS and the CMS, auditors may also refer a case to state or federal law enforcement agencies in the event they discover potential evidence of healthcare fraud. Given the stakes involved, any pharmacy subject to an NGS Medicare audit should immediately protect its interests by reaching out to a knowledgeable PBM audit attorney.