Fiduciary Risk Mitigation

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PBM Negotiator

Protecting Plan Sponsors Through Strategic PBM Contract Management

Mitigating Fiduciary Risk in PBM Agreements

Fulfilling fiduciary responsibilities is a critical priority for plan sponsors. With increasing regulatory scrutiny surrounding Pharmacy Benefit Managers (PBMs) and new state and federal legislation targeting pricing transparency, rebate structures, and spread pricing, ensuring that PBM agreements align with fiduciary duties has never been more important. At PBM NEGOTIATOR™, we specialize in fiduciary risk mitigation, helping plan sponsors navigate these complexities and safeguard their interests through comprehensive contract oversight and proactive compliance strategies.

The Importance of Fiduciary Risk Management

Plan sponsors face significant liabilities if their PBM agreements fail to meet fiduciary standards. Opaque pricing, hidden fees, and misaligned rebate practices can expose organizations to regulatory penalties, legal challenges, and reputational risks. Our Fiduciary Risk Mitigation service is designed to:

  • Identify Potential Liabilities: Detect contract clauses and pricing structures that pose fiduciary risks or fail to align with new regulatory requirements and best practices.
  • Implement Compliance Measures: Ensure that PBM agreements reflect updated legislative mandates, particularly those requiring cost transparency, rebate disclosures, and fair pricing practices.
  • Protect Plan Sponsors: Reduce fiduciary liability exposure through comprehensive contract review, risk assessments, and strategic recommendations for negotiation or updates.
 
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Years of Experience

Our collective experience delivers consistent results.

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Cases

Relevant matters and negotiations, prepared for all the possibilities.

Our Fiduciary-Focused Approach

 

PBM NEGOTIATOR™’s approach to fiduciary risk mitigation is both comprehensive and proactive. We understand that plan sponsors must act in the best interests of their participants, and our services are designed to support this responsibility effectively. Our process includes:

  • Detailed Contract Assessment: We conduct a thorough review of current PBM agreements to identify potential fiduciary risks, including hidden fees, rebate misalignment, and non-compliance with evolving regulatory requirements.
  • Custom Risk Mitigation Strategies: Our team develops tailored strategies to address identified risks, including contract revisions and negotiations that strengthen protections for plan sponsors.
  • Ongoing Compliance Monitoring: We provide continued oversight to ensure that PBM agreements remain aligned with fiduciary obligations as laws and regulations evolve.

Ensuring Fiduciary Peace of Mind

One of our recent clients, a large employer-sponsored health plan, faced significant fiduciary risk exposure due to ambiguous PBM contract language and non-transparent pricing structures. Through our Fiduciary Risk Mitigation service, we identified contract provisions that required renegotiation and guided the client through the contract update process. The result was a revised PBM agreement that not only aligned with new transparency laws but also secured stronger participant protections and reduced fiduciary liability.

Key Benefits of Our Fiduciary Risk Mitigation Service

By partnering with PBM NEGOTIATOR™, plan sponsors gain:

  • Regulatory Compliance: Assurance that PBM agreements meet all current legislative requirements, including pricing transparency, rebate disclosures, and cost-sharing mandates.
  • Enhanced Fiduciary Protection: Proactive strategies to identify and mitigate risks, reducing exposure to legal, financial, and compliance-related consequences.
  • Long-Term Security: Ongoing monitoring and updates to PBM contracts, ensuring that agreements evolve with legislative changes and remain in full compliance.


Client-Centric Fiduciary Support

At PBM NEGOTIATOR™, we prioritize your fiduciary responsibilities. Our team is dedicated to delivering personalized service that aligns with your organization’s strategic and financial goals. From the initial contract assessment to ongoing compliance support, we provide the expertise and resources needed to effectively manage fiduciary risks in PBM agreements.

Partner with PBM Negotiator for Fiduciary Assurance

Fiduciary risk mitigation isn’t just about checking the compliance box—it’s about establishing a secure framework that protects your organization’s long-term success. With PBM NEGOTIATOR™’s comprehensive approach, you can confidently manage PBM agreements and fulfill your fiduciary responsibilities with greater assurance.

Contact PBM NEGOTIATOR™ today to learn more about how our Fiduciary Risk Mitigation service can strengthen your pharmacy benefits strategy and protect your role as a plan sponsor.

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