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1

CMS Issues New Guidance Addressing Spread Pricing in Medicaid ...

May 15, 2019 Spread pricing occurs when health plans contract with pharmacy benefit managers (PBMs) to manage their prescription drug benefits, and PBMs keep...

www.cms.gov
2

PBMs' spread pricing inflates healthcare spending, commission finds

Jun 5, 2019 In the spread pricing model, the PBM charges a payer more than it reimburses the pharmacy for a certain drug and retains the difference.

www.modernhealthcare.com
3

What Is the Price Anyway? - The Actuary Magazine

Thus, there is a spread between the amount that the health plan pays the PBM and the amount that the PBM reimburses the pharmacy for a beneficiary's...

theactuarymagazine.org
4

Know Your Issue: Spread Pricing - DPAC

Jun 6, 2019 “Spread pricing occurs when health plans contract with [PBMs] to manage their prescription drug benefits, and PBMs keep a portion of the...

diabetespac.org
5

CMS cracks down on spread pricing by pharmacy benefit managers

May 15, 2019 Spread pricing occurs when health plans contract with a pharmacy benefit manager to manage their prescription drug benefits, and PBMs keep a...

www.healthcarefinancenews.com
6

In Drug Pricing, PBMs Called the “Arsonist and the Firefighter in One”

Dec 15, 2020 One way that PBMs have capitalized on their position is spread pricing, in which they keep a portion of the amount billed to health plans for...

www.ajmc.com
7

Prohibition of Spread Pricing in Medicaid MCO Contracts | KFF

Spread pricing refers to the difference between the payment the pharmacy benefit manager (PBM) receives from the MCO and the reimbursement amount it pays to the...

www.kff.org
8

What is Spread Pricing and How Does It Affect Drug Costs?

Often what the health plan pays and what the pharmacy receives is a different amount. This difference between what is received by a PBM from a health plan and...

www.haloscrips.com
9

Spread Pricing: From Largely Unknown To Much Scrutinized and ...

Mar 23, 2021 Spread pricing is the difference between the amount a PBM pays to a pharmacy when a prescription is purchased and what it turns around and...

www.managedcaremag.com

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