2021 Pharmacy Benefits Conference: PBM Assessments: Nothing Glamorous…but Essential
Published: April 6, 2021
Plan sponsors have a fiduciary responsibility under ERISA and CMS (for Part D programs) to ensure the proper administration of employee benefit’s programs including the pharmacy benefit component. The proper administration is validated via assessments of the programs ranging from traditional ‘pricing’ and rebate assessments to Prior Authorization (PA), Fraud, Waste & Abuse (FWA) and customer service. This session will inform the audience of:
• The types of pharmacy program assessments.
• The recommended frequency of performing such program assessments.
• The limitations that vendors may place on a plan sponsors’ ability to assess their pharmacy programs and ways to ensure plan sponsors retain the ability to truly assess the accuracy of their plan administration.
• The key questions to ask when looking for a partner to assess your pharmacy program.
Eric Michael, PharmD, Managing Director, Pharmacy Practice Leader, PwC