Understanding the legal framework that protects your pharmacy benefits
Illinois law requires PBMs to provide audit rights to plan sponsors. This legislation ensures transparency in pharmacy benefit management and gives employers the legal basis to review their PBM contracts for compliance.
Indiana's PBM regulations establish clear requirements for transparency and audit rights. These laws protect plan sponsors and ensure that PBMs operate with accountability in their pricing and contract practices.
For administrators and trustees of Long-Term Care facilities, ensuring PBM compliance is not optional—it's a fiduciary obligation.
Failing to audit PBM contracts can result in significant financial losses that could have been recovered. Each year of non-compliance represents a potential breach of fiduciary duty.
Regular compliance audits demonstrate proactive stewardship. In Illinois and Indiana, exercising your audit rights shows stakeholders that you are committed to transparency.
South Shore Benefits Auditing LLC operates with strict adherence to all applicable laws and regulations. Our fee structures are based entirely on state requirements in Illinois and Indiana. We maintain full transparency with every client and never engage in practices that could jeopardize your facility's compliance standing.
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