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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.
6. The Merit-Based Incentive Payment System is a new program in the Medicare fee-for-service payment system. It consolidates three existing programsâmeaningful use (MU), the Physician Quality Reporting System (PQRS), and the Value-Based Payment Modifier (VBPM)âinto a single program.