Rising Risk of Pharmacy Benefits
Rising Risk of Pharmacy Benefits Board Directors Are Now Named Defendants Recent lawsuits against major corporations highlight a growing risk: PBM mismanagement is leading to overspending,…
Category: Contracts & Terms
Healthcare contract provisions, transparency, accountability, negotiating terms, and protections for employers and plan participants.
Controlling Medical Benefit Drug Spending
Employers target PBMs to curb drug costs but often miss a big issue—specialty J-code drugs billed under medical benefits
Mental Health Benefits
Adequate mental health benefits are a fiduciary responsibility and growing legal risk for employer health plans.
Mastering Health Plan Contracts
Mastering Health Plan Contracts Are Your Contracts Hurting Your Plan? Many employers assume their health plan contracts are well drafted. In reality they are often one-sided…
Direct Contracting
Direct Contracting Game-Changer for Cost and Convenience Employers must find new ways to deliver high-quality, cost effective care. One strategy gaining traction is Direct Contracting. Employers…
10 New Year’s Resolutions
10 New Year's Resolutions For Health Plan Fiduciaries