Are your pharmacy benefits being adjudicated properly?

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By Brian N. Anderson | 01 May 2014

While almost all pharmacy benefit manager (PBM) contracts include audit provisions, many plan sponsors underestimate the value of auditing their PBM, which can help recover funds lost through overpayments or system errors. Recovered losses mean that a typical pharmacy benefit audit claim more than pays for itself, but at the very least ensures plan sponsors that they are meeting fiduciary responsibilities in the area of managing it's PBM contract.

Reproduced with permission from Benefits Magazine, Volume 51 Number 5, May 2014, pages 22-27, published by the International Foundation of Employee Benefit Plans (, Brookfield, Wisconsin. All rights reserved. Statements or opinions expressed in this article are those of the author and do not necessarily represent the views or positions of the International Foundation, its officers, directors or staff. No further transmission or electronic distribution of this material is permitted. Subscriptions are available (