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PBM Contracting Best Practices: Ensure Your Audit Language is Well-Defined

Presenters: Derek Frye, Audit and Compliance Practice Leader; Steve Baumgardner, Procurement and Key Markets Practice Leader; Yvonne Zachman Fiedler, Senior Consultant


For health plans needing to tighten the reins on drug costs and perform PBM oversight, auditing your PBM is one of several highly effective tactics you can use. But the effectiveness of your audits will hinge largely on what language is included in your PBM contract.

In this webinar, The Burchfield Group’s leading pharmacy benefits experts will discuss why it’s critical for health plans to include the appropriate audit rights language in the PBM contract. You will learn:

  • Why you need to have broad PBM audit rights to ensure you ultimately receive the maximum savings and discounts that your plan is entitled to.

  • Why PBM contract language can be vague and subject to interpretation – and how having the right audit language gives health plans the upper hand.

  • Common pitfalls to avoid when drafting or reviewing PBM contract language.

  • Real life examples of how health plans that lacked the right PBM auditing privileges were financially impacted.

  • How to optimize auditing language and related provisions in your contracts to enhance PBM vendor oversight and better manage vendor risk.

  • What to specify in your contracts regarding audit scope, timeframes, expenses, blackout dates and more.

Presenters: Derek Frye, Audit and Compliance Practice Leader; Steve Baumgardner, Procurement and Key Markets Practice Leader; Yvonne Zachman Fiedler, Senior Consultant

The webinar recording can be accessed here.
 
The webinar slides can be accessed here.
 

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