Minimizing Legal Risk in

Pharmaceutical Benefit Management

Monday, April 18, 2005

About

In recent years, PBMs, not unlike the pharmaceutical and medical device companies with which they contract, have found themselves at the center of numerous investigations and other controversies. State Attorneys General have subjected PBMs to fraud and abuse investigations concerning their business arrangements with pharmaceutical manufacturers. Critics of PBMs have supported legislative proposals to restrict their activities at the state level. Congress has requested that the Federal Trade Commission investigate PBMs for potential conflict-of-interests. Moreover, Medicare Part D sponsorship presents its own set of challenges as it may require a shift in the traditional PBM business model.

In this evolving and unsettled environment, counsel and executives for PBMs must have an in-depth and complete understanding of the latest legal, regulatory, legislative and political developments affecting pharmaceutical benefit management today. American Conference Institute in association with PCMA created a second conference on Minimizing Legal Risk in Pharmaceutical Benefit Management that provided attendees with the latest and most up-to-date information concerning these developments.

Industry experts in pharmaceutical care management have provided key insights on how Medicare reform, state legislative challenges, federal and state investigations and private litigation are affecting legal risk for PBMs in the publication from this conference, a collection of presentation materials from an outstanding faculty of leading attorneys, government representatives, federal and state prosecutors, and consultants. Read presentations on:

  • Strategies for dealing with challenges presented by Medicare reform and state legislative initiatives
  • Disclosure, transparency and consumer protection
  • The impact of PCMA v. Rowe and related cases on disclosure and transparency requirements under federal and state legislation
  • How to avoid violations of patient privacy in practices routine to pharmaceutical care management
  • Medication safety measures: why PBMs should be concerned

Contents & Contributors

About

In recent years, PBMs, not unlike the pharmaceutical and medical device companies with which they contract, have found themselves at the center of numerous investigations and other controversies. State Attorneys General have subjected PBMs to fraud and abuse investigations concerning their business arrangements with pharmaceutical manufacturers. Critics of PBMs have supported legislative proposals to restrict their activities at the state level. Congress has requested that the Federal Trade Commission investigate PBMs for potential conflict-of-interests. Moreover, Medicare Part D sponsorship presents its own set of challenges as it may require a shift in the traditional PBM business model.

In this evolving and unsettled environment, counsel and executives for PBMs must have an in-depth and complete understanding of the latest legal, regulatory, legislative and political developments affecting pharmaceutical benefit management today. American Conference Institute in association with PCMA created a second conference on Minimizing Legal Risk in Pharmaceutical Benefit Management that provided attendees with the latest and most up-to-date information concerning these developments.

Industry experts in pharmaceutical care management have provided key insights on how Medicare reform, state legislative challenges, federal and state investigations and private litigation are affecting legal risk for PBMs in the publication from this conference, a collection of presentation materials from an outstanding faculty of leading attorneys, government representatives, federal and state prosecutors, and consultants. Read presentations on:

  • Strategies for dealing with challenges presented by Medicare reform and state legislative initiatives
  • Disclosure, transparency and consumer protection
  • The impact of PCMA v. Rowe and related cases on disclosure and transparency requirements under federal and state legislation
  • How to avoid violations of patient privacy in practices routine to pharmaceutical care management
  • Medication safety measures: why PBMs should be concerned

Contents & Contributors


PCMA STATE LEGISLATIVE UPDATE
Peter F. Harty, Medco Health Solutions, Inc.

PBMS AND THE MEDICARE PRESCRIPTION DRUG BENEFIT: AN EXPLORATION OF PART D SPONSORSHIP OPTIONS AND THEIR VIABILITY
John Richardson, The Health Strategies Consultancy LLC

PBMS AND GOVERNMENT PAYOR SYSTEMS: ANTICIPATING AND AVOIDING PITFALLS IN PART D
Carolyn J. McElroy, Mintz, Levin, Cohn, Ferris, Glovsky & Popeo, P.C.

PBMS AND TRADITIONAL MARKET CHANNELS: THE LESSONS OF HISTORY AND ECONOMICS
Jack E. Calfee, American Enterprise Institute

PCMA V. ROWE: LESSONS LEARNED
John J. Aromando, Pierce Atwood LLP

DISCLOSURE, TRANSPARENCY AND CONSUMER PROTECTION
Stephanie Kanwit, Pharmaceutical Care Management Association (PCMA)

UPDATE ON THE FTC'S VIEWS AND FINDINGS RELATIVE TO PHARMACEUTICAL BENEFIT MANAGEMENT
Maureen K. Ohlhausen, Federal Trade Commission

UPDATE ON FTC'S VIEWS AND FINDINGS ON PBM MARKET
Seth C. Silber, Federal Trade Commission

SAFEGUARDING PATIENT PRIVACY IN ROUTINE PBM PRACTICES
Kevin C. Lacey, K & R Law Group

MEDICATION SAFETY MEASURES: WHAT PBMS SHOULD KNOW AND WHY THEY SHOULD BE CONCERNED
Edmond S. Weisbart, MD, CPE, Express Scripts, Inc.

PBM LITIGATION: LIABILITY THEORIES AND PENDING ACTIONS
William G. Schiffbauer, Schiffbauer Law Office

TO SEE OR NOT TO SEE: HOW MUCH TRANSPARENCY IS APPROPRIATE IN PBM MARKETS?
James A. Donahue, III, Office of the Pennsylvania Attorney General
Julie Brill, Vermont Attorney General's Office

MANAGING RISK UNDER THE PRESCRIPTION DRUG BENEFIT
Lindy M. Hinman, The Health Strategies Consultancy LLC



DOCUMENT TYPES: PRESENTATIONS AVAILABLE: 0