Tag Archives: PBM Consulting

No, not that word! The other “F” word…Fiduciary!  At WBC (www.wbcbaltimore.com) we have been asking our clients to keep this word in mind.  Trustees of multi-employer plans (and other types of plan sponsors) need to remember that the decisions they make are guided by the judgement of being a fiduciary.   This means that their decisions […]

On May 18, 2016, the Department of Health and Human Services (“HHS”) published a final rule to implement Section 1557 of the Affordable Care Act (“ACA”), which prohibits discrimination in health coverage and care based on race, color, national origin, age, disability and sex.  These provisions incorporate existing federal non-discrimination law and policy and also […]

One of the most important contractual elements in a Pharmacy Benefit Manager’s (“PBM”) service agreement that is used in pharmacy benefit cost reduction is the definition  and utilization of the MAC (“Maximum Allowable Cost”) list.  The MAC generally refers to a PBM-generated list of products that includes the upper limit or maximum amount that a […]