Recent regulatory changes to the process state Medicaid pharmacy programs receive rebate payments from drug manufacturers are having significant implications for managed care pharmacy.
Implications of AMP Cap Removal and 3 Questions All Plan Sponsors Should Ask their PBM Read More »
On February 5, 2024, a class action complaint was filed against one of the nation’s largest self-funded employers, Johnson & Johnson (J&J). In the case, Lewandoski v. Johnson & Johnson, the proposed class is claiming that J&J failed to uphold their fiduciary duty of prudence under ERISA.
As we begin another year, several major trends from 2023 will continue to drive key changes in the pharmacy benefit market for health plans and other plan sponsors. In this article, we detail three important trends worth following throughout 2024
Three Pharmacy Benefit Trends to Watch in 2024 Read More »
In 2023, the pharmacy benefit management (PBM) industry witnessed a significant shift in client sentiment. Health plans, employers, health systems and unions reported a notable decrease in satisfaction with their PBM vendors, as detailed in the 2023 Pharmacy Benefit Manager Customer Satisfaction Report by Pharmaceutical Strategies Group (PSG).
In this article, HealthPlan Data Solutions’ (HDS) claims analysts will review the purpose and limitations of traditional PBM audits, offer insights to help health plans establish robust pharmacy payment integrity programs, and provide suggestions to enhance accountability in the pharmacy benefit.
