Billing and Collections Practices of Coffeyville Regional Medical Center

The legal requirement that the welfare of patients is the primary duty and obligation of any
PBM aligns their responsibilities with those of every other state regulated entity in
healthcare. This alignment is good news for patients as is legal standing if a PBM causes
patient harm. Pharmacy benefit managers have an influential role in healthcare, to design
and administer prescription drug benefits. Every element of the benefit design directly
translates into how accessible medications are to patients who need them: Is the drug
listed on the formulary? What is the out-of-pocket cost? Is prior authorization required? If
so, how are decisions made, by whom and is there a way to appeal? Is mail the only option?