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This billing practice is known as a “clawback” and you may have no idea it’s happening to your employees or how it impacts your pharmacy costs. Furthermore, pharmacists aren’t allowed to tell patients, under a gag order, that restricts pharmacists from telling patients they are being
These clawback monies are a contributing factor to the unchecked service fees non-fiduciary PBMs rely upon to cover overhead.
It’s all about the contract.
1) Demand radical transparency
2) Negotiate financial and nonfinancial contracting terms for both direct and indirect revenues
3) Get educated