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Pharmacy Benefit Manager Reform: What’s on the Horizon? (December 2023 Update)

McDermott Will & Emery Employee Benefits

Pharmacy benefit managers (PBMs) are a key stakeholder in the drug supply chain, functioning as intermediaries between insurance providers and pharmaceutical manufacturers. Congress and […] The post Pharmacy Benefit Manager Reform: What’s on the Horizon?

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Pharmacy Benefit Manager Reform: What’s on the Horizon?

McDermott Will & Emery Employee Benefits

Pharmacy benefit managers (PBMs) are a key stakeholder in the drug supply chain, functioning as intermediaries between insurance providers and pharmaceutical manufacturers. PBMs administer […] The post Pharmacy Benefit Manager Reform: What’s on the Horizon? appeared first on EMPLOYEE BENEFITS BLOG.

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Tariffs and Health Benefits: The Hidden Cost Employers May Not Be Able To Ignore

CorpStrat

But heres the hidden truth: tariffs may quietly drive up the cost of employer-sponsored health benefits, affecting your bottom line and your ability to attract and retain talent. Pressure on Carriers = Narrower Plans To manage rising costs, insurers may restrict provider networks or increase cost-sharing.

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Why Mid-Sized Employers Should Look at Employee Benefits Captives

Griffin Benefits

Captive insurance can be an ideal solution for medical benefits, offering mid-sized companies across most industries the opportunity to control medical and pharmaceutical costs and design a more customized health plan. Those who choose to pursue a captive for employee benefits should: Find the right captive for the organization.

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Tenth Circuit Reaffirms Preemption of State Pharmacy Network Regulations

McDermott Will & Emery Employee Benefits

The US Court of Appeals for the Tenth Circuit recently held in Pharmaceutical Care Management Association v. Mulready (PCMA) that the Employee Retirement Income Security Act (ERISA) and Medicare Part D preempted several provisions of Oklahoma law regulating pharmacy benefit managers and pharmacy networks.

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The impact of rising health care costs on public sector budgets

Higginbotham

Budgetary Strain on Benefits One of the most significant impacts of these changes for public sector entities hits the overall administration and budget for their employee benefits. This strain forces public sector entities to make difficult decisions in regard to benefit design, cost-sharing and overall plan affordability.

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3 Ways to Strengthen Cost Management for Pharmaceutical Benefits

Griffin Benefits

Here are three ways to manage the cost of pharmaceutical benefits. If employers/plan sponsors and their pharmacy benefit managers (PBMs) can’t control the runaway costs for specialty drugs, they can at least slow the cost impact on the pharmacy benefit. Focus on fundamentals for Rx cost savings.