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Historically, a pharmacy benefit manager (PBM) is a third-party administrator of prescription. drug programs. PBMs are primarily responsible for developing and maintaining the. formulary, contracting with pharmacies, negotiating discounts and rebates with drug. manufacturers, and processing and paying prescription drug claims.
Private fee-for-service plan (PFFS) is a type of medicare advantage plan which give private insurance companies access to the vast medicare market.It helps to privatize medicare by allowing beneficiaries to go to any medicare-approved doctor or hospital that accepts the planâs payment.n PFFS, the insurance plan decides the amount to be paid for the services received. Medicare pays a set amount each month to a private insurer to provide health coverage on a fee-for-service basis to medicare beneficiaries.