Elisa Muller, Vice President of Legal and Chief Compliance Officer of LucyRx, recently authored an article in BenefitsPRO about pharmacy benefit reform—the legislative efforts to increase transparency, fairness and accountability in the PBM industry.
“Although reform may be complex, your responsibility to protect your people, budget and bottom line is simple,” Elisa wrote.
In the article, she outlines the reasons why reform is accelerating and provides three key takeaways for employers:
- Don’t wait for legislation. Statehouses are moving fast, and laws like Florida’s pass-through mandate are already effective. If your PBM isn’t nimble, find one that is.
- Know your contract. Offering “100% pass-through” doesn’t mean much if it’s not defined. Audit rights, change-in-law protections and annual market checks should be included in PBM agreements.
- Lead with people. ERISA calls it fiduciary duty; LucyRx calls it doing right by your employees. That means ensuring savings flow back to your plan and that employees aren’t saddled with unnecessary out-of-pocket costs.
She also shares LucyRx’s PBM Reform Readiness Checklist, a 10-minute exercise that can help employers see deficiencies in their PBM contracts, prepare for reform’s financial repercussions and ensure their employees are able to access and afford the care they need.
“It’s easy to stand by and let the dust settle, but leaders shouldn’t wait to be told what reform means,” Elisa wrote in the article.
Read the full article in BenefitsPRO: Prescription benefit reform is here: Is your PBM ready?
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