Express Scripts, Inc. - Contract No. 11023

As part of our annual audit plan, we performed an audit of costs billed to the Tennessee Valley Authority (TVA) by Express Scripts, Inc. (ESI) for pharmacy benefits management services under Contract No. 11023. Our audit objective was to determine if costs were billed in accordance with the terms of the contract. Our audit scope included approximately $95.8 million in costs billed to TVA from January 2, 2021, through October 18, 2022. In summary, we determined: ESI overbilled TVA $1,291,051 in maintenance medication refill claims that were in excess of the contract's three 30-day supply refill limits for maintenance medications. ESI billed TVA $20,078 in duplicate claim costs. (Summary Only)