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In the United States, a pharmacy benefit manager (PBM) is a third-party administrator of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans. [1][2] PBMs operate inside of integrated healthcare systems (e.g ...
Kentucky and West Virginia started using one PBM, saving Kentucky’s Medicaid program $282 million in 2021 and 2022 and West Virginia’s Medicaid program an estimated $54.4 million in 2018.
Express Scripts. Express Scripts Holding Company is a pharmacy benefit management (PBM) organization. In 2017 it was the 22nd-largest company in the United States by total revenue as well as the largest pharmacy benefit management (PBM) organization in the United States. [2] Express Scripts had 2016 revenues of $100.752 billion. [2]
Pharmacy benefit managers (PBMs) are in the crosshairs of Republicans and Democrats in Congress but have so far dodged any new litigation or reforms that had been targeted for inclusion in last ...
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Pharmacy Benefit Managers, or PBMs, act as a sort of middleman between insurance agencies, employers that pay for employee health plans and pharmacies for facilitation fees. They also regulate ...
Catamaran Corporation (formerly SXC Health Solutions) is the former name of a company that now operates within UnitedHealth Group's OptumRX division (since July 2015). It sells pharmacy benefit management and medical record keeping services to businesses in the United States [3] and to a broad client portfolio, including health plans and employers. [4]
Linda Cahn is the founder and president of a nationwide consulting firm, Pharmacy Benefit Consultants. The firm assists corporations, unions, government entities and insurance companies in improving their prescription coverage benefits and decreasing their prescription coverage costs. Cahn’s expertise related to prescription coverage arises ...