Paul B. Holmes

Practice Details

• Firm Information
  Position

  Partner

  Firm Name

  Williams Barber & Morel Ltd.
• Representative Cases & Transactions
  Cases

  Representative Matters: Paul has logged over 8,000 hours during the past 4-5 years, advising large employers
  Taft-Hartley welfare funds managing their prescription drug benefit plans. This work includes active oversight of the RFP process for selecting a PBM, the negotiation of final PBM contracts (including pricing, rebates
  audit rights),
  regular audits of PBM compliance with their contracts.
  Providing guidance on the customization of PBM drug formularies
  PBM prior authorization protocols, to neutralize the PBMs' bias as the primary sellers of prescription drugs to a plan.
  Providing guidance on 'deeper dive' audits of PBM pricing, rebates
  claims processing compliance, as st
  ard audit protocols are not all-inclusive.
  Providing guidance on the selection of independent pharmacy benefit consulting firms (who do not receive indirect compensation from the PBMs), which independence is expressly required under Section 202 of Consolidated Appropriations Act of 2021 ('CAA').
  Providing fiduciary training for the administration of large prescription drug benefit plans, including best practices regarding the RPF process, the negotiation of PBM contracts
  the negotiation of pharmacy benefit consultant service agreements. These efforts are necessary to clarify vendor service obligations, obtain fair market pricing, avoid conflicts of interest, help control plan costs
  otherwise protect plan fiduciaries.
  Providing deep subject matter support to firm litigators in dispute resolution, arbitration
  litigation against large PBMs
  financially conflicted pharmacy benefit consultants.