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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.
view profile. Peggy MacePRO. President and Senior Agent, Outlook Life, Most of the U.S. A Prospective Payment System (PPS) is a method of reimbursement to Medicare providers that is intended to motivate them to provide patient care efficiently and effectively without spending on unnecessary services.