Why Health Plans Should Audit their PBM Rebates
By Derek FryeTue, Jun, 25, 2019
PBM rebate potential has been growing rapidly due to increased utilization of specialty and other high-price brand drugs. In fact, billions of PBM rebate dollars are at stake each year for health plans, their clients, and, ultimately, members. From a financial standpoint, it is more imperative than ever that health plans audit their PBM rebates to ensure they are recouping the dollar amounts they are entitled to.
Sharon Moritz & Derek FryeThu, Jun, 01, 2017
- How PBMs Make Money in the Medicare Part D Market – A GAO Report Analysis
- PBM Impact from COVID-19
- CMS Issues New Proposed Protocols for Medicare Part C and D Program Audits and Part C Timeliness Monitoring Project. Proposed Changes Would Take Effect in 2021 Audit Year.
- What Health Plans Need to Know about Medicaid Encounter Data
- CMS Audits for 2020: Changes Amid COVID-19 Crisis