PBM Pricing Audits: Key Emerging Contract Practices and Protocols
Join The Burchfield Group to learn about the value of conducting PBM pricing audits, the importance of having strong protections in your PBM contracts concerning audit rights and protocols, and why it’s critical to complete a 100% valuation of all PBM contract terms that can impact your claims pricing.
Minding the Guarantee Gap: Navigating the Fine Print of a PBM Offer
Navigating Pharmacy Benefit Manager (PBM) contract guarantees to improve pricing can be challenging for health plans. PBMs will commonly exclude certain guarantees in their contracts, such as for products deemed difficult to forecast for discount and rebate purposes.
PBM Benefit Audits: Understanding Health Plan Rights and Best Practices
In this webinar, The Burchfield Group’s audit and compliance experts will discuss why it’s more important than ever that health plans conduct PBM benefit audits regularly – and what’s involved.
CMS Mock Audits: Best Practices and Other Strategies for Your 2020 Program
In this webinar, The Burchfield Group’s CMS compliance experts will discuss why it’s important to conduct a CMS mock audit, what’s involved, and how to effectively prepare.
CMS Data Validation: Using Pre-Assessments and Other Best Practices to Maximize Your Scores
In this webinar, The Burchfield Group’s CMS data validation experts will detail CMS’s latest scope of Data Validation (DV) requirements (subject to change annually) and implications for MAOs.
Medicaid Compliance for Health Plans: Best Practices to Manage Your Risks
In this webinar, The Burchfield Group’s health plan and compliance experts will guide you through specific areas within Medicaid contracts that pose the biggest compliance risks for health plans – large and small.
Medicare Oversight: Best Practices for CMS Compliance Program Effectiveness Audits
In this webinar, The Burchfield Group’s health plan and compliance experts will discuss how to implement a robust, actionable CPE audit that truly benefits your organization and demonstrates value.
New CMS Audit and Enforcement Initiatives: How Health Plans Can Prepare Now
In this webinar, The Burchfield Group’s pharmacy benefits experts will clearly distill and explain the new audit protocols and documentation requirements so your plan won’t be caught off guard.
PBM Procurement: How to Maximize Your Leverage in Today’s Market
In this webinar, The Burchfield Group’s leading pharmacy benefits experts will show you best practices and approaches for renewing your PBM contract or putting it out to bid – so you can get the best pricing and guarantees on all fronts.
PBM Contracting Best Practices: Ensure Your Audit Language is Well-Defined
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.
PBM Rebate Audits: Tips for Health Plan Success
In this webinar, we will discuss several critical ways health plans can benefit from conducting a PBM rebate audit – and more.
Best Practices for Developing an Effective PBM Oversight Strategy
In this webinar, The Burchfield Group’s leading pharmacy benefits experts will discuss why it’s more important than ever that employers adopt a multi-year PBM oversight strategy – and which components to focus on when.
Understanding the PBM Contracting Cycle: Get the best pricing and leverage market disruption to your advantage
PBM pricing continues to evolve very rapidly in the market place. Consolidation has played a large role in this evolution and continues to drive competition in new ways.
PBM Rebate Audits: Securing the full value of manufacturer discounts
PBM payments to clients from manufacturer rebate contracts have increased dramatically over the past few years. Some clients are experiencing a 30% increase in rebate payments year over year, and minimum rebate guarantees are being exceeded by up to 50%.
After CMS Program Audits: A deeper dive into the Independent Validation Audit Process
We heard your feedback following Burchfield’s CMS Program Audit webinar in September and are going to dig deeper into what health plans need to know to close out their program audit successfully.
How to Prepare for CMS Audits in 2018 and Beyond
In this webinar, you will learn how to break down the CMS audit readiness cycle into manageable segments, and what steps to take to ensure your plan can emerge from its next audit unscathed.