Correct me if I'm wrong but isn't this exactly what I questioned. The difference from what the company bills and claim as income compared to what they actually recieve from the insurance coverage?
Your Post:
"During the second quarter, Direct and Indirect Remuneration (DIR) Fees applied significant downward pressure on the Company’s profitability. DIR Fees are PBM clawbacks of reimbursements based on factors that vary from plan to plan. These fees lack transparency and are extremely difficult to predict and accrue. DIR fees are often applied retroactively, which has caused the fees in the second quarter to be nearly 300% higher than the first quarter. The Company has already shifted pharmacy policy to take into account anticipated DIR clawbacks and we expect to limit the losses incurred by DIR through the remainder of the year. Part of the mitigation policy includes our focus on performance as some PBMs may reduce or return DIR Fees based on the performance of the pharmacy within their network. As of May 2017, the Company’s performance ranks in the 90th percentile based on a 6 month average between comparative rankings in all PBM networks."