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OCTOBER 7, 2022

Navigating Legal Pitfalls in Payor– PBM Networks

By Karen Blum

PHOENIX—The price of failing to accurately navigate specialty pharmacy networks can range from one-year bans to attracting the eye of auditors looking for prescription and copay collection errors, prior authorization violations and other operational missteps. Such scrutiny is enough to keep even the most seasoned managers up at night.

Fortunately, there are strategies for steering clear of trouble when pursuing and then participating in specialty pharmacy networks, according