Lead with the Contract
Most PBM procurements get the sequence backwards: pick the PBM, then fight over the contract. That’s a recipe for weak leverage and fiduciary risk.
Category: PBM
Pharmacy benefit manager practices, contracting, economics, transparency, and strategies for improving pharmacy benefits.
From Frustration to Fix: The PBM Field Guide
From Frustration to Fix: The PBM Field Guide We’re putting PBM procurement back in the hands of fiduciaries at RosettaFest Executive Brief Two Big Moments. One…
The Contract That Protects or Betrays
The Contract That Protects or Betrays When Fiduciary Duty Meets Contract Fine Print Most contracts protect the drafter. Healthcare vendor contracts go one step further: they…
PBM Procurement Without the Pain
PBM Procurement Without the Pain A New Open Source Tool to Cut Through Contracts, Conflicts, and Compliance Risks Executive Brief The biggest ERISA class-action lawsuits have…
Signed, Sealed… Sued?
Signed, Sealed… Sued? If You Didn’t Write the Contract, You’d Better Rewrite the Rules. Most health plan contracts come pre-written—by brokers, vendors, or consultants. But when…
The Death of Common Sense
When Five-Figure Pills Deliver Three-Week Benefits, Fiduciaries Must Intervene
The PBM Reform Playbook
The PBM Reform Playbook State Legislatures Are Doing What Congress Hasn’t Executive Brief State legislatures are cracking down on PBM profit games—banning spread pricing, requiring rebate…
PBM Illusions, Exposed
PBMs thrive on confusion. Bold employers are demanding receipts—and revealing just how costly that confusion really is.
What I Learned from 25 Newsletters
What I Learned from 25 Newsletters And a Lot of Lawsuits Executive Brief Welcome to Issue #26 of The Health Plan Compliance Advantage. Most newsletters don’t…
The Fiduciary Lawsuit That Could Change Everything
The Fiduciary Lawsuit That Could Change Everything No More “We’re Just Administrators” TPA Defense Executive Brief Can a TPA avoid ERISA liability by calling itself an…