Pharmacy Benefits and PBM Contracting

Engaging at every stage of the procurement process, Mintz empowers health plans to navigate PBM negotiations with confidence by leveraging our breadth and depth of experience to mitigate risks and seize opportunities. Mintz provides comprehensive legal guidance to health plans throughout negotiations with PBMs to transform the delivery of pharmacy benefit services in commercial and government health care programs. Our seasoned attorneys adeptly unravel contract complexities by crafting clear, enforceable terms to clearly establish responsibilities, and optimize leverage and operational performance while building in the flexibility to anticipate and account for regulatory and market shifts.  Our team has negotiated and drafted pharmacy benefit agreements with every major national PBM and many other entities in the pharmacy supply chain.   With expertise in crafting contracts for integrated and modular pharmacy benefit programs, we draft provisions that withstand negotiations with national PBMs, which ensures unmatched client advantages.

We are one of the few legal teams in the country who structure, draft, and negotiate “modular” PBM agreements, which break the traditional “all-inclusive” PBM agreement into smaller modular components to maximize competition, outcomes, and options for payers.