Jessica Johnson, clinical consultant at Prime Therapeutics, shares how the Special Investigations Unit (SIU) helps prevent fraud, waste and abuse (FWA) in health care

Jessica Johnson, clinical consultant at Prime Therapeutics, shares some ways to avoid common fraud schemes

Jessica Johnson, clinical consultant at Prime's Special Investigations Unit, shares tips to stay safe when using online pharmacies

Jessica Johnson, clinical consultant at Prime Therapeutics, shares more about common GLP-1 fraud schemes

Jessica Johnson, clinical consultant at Prime's Special Investigations Unit, shares tips to identify fraud

Jessica Johnson, clinical consultant at Prime Therapeutics, shares more about common fraud schemes in health care.

Jessica Johnson, clinical consultant at Prime, shares some tips to stay safe

Jessica Johnson, clinical consultant at Prime's Special Investigations Unit, shares tips to properly dispose of unused or expired medications

Care Management feature offers holistic assessment that helps support members by mitigating fraud, waste and abuse and patient safety concerns

Prime’s Special Investigations Unit is specially trained to protect patients and providers throughout the health care continuum

When a member obtained diabetic supplies from 73 unique pharmacies and 53 prescribers, here’s how Prime worked closely with the insurance company to intervene

An individual obtained more than a dozen inhalers from scores of pharmacies and prescribers. Here’s how Prime took a collaborative approach to intervene.

Nationwide effort on April 26 offers opportunity to safely dispose of unused or expired medications

Mitch Scott, senior director, Special Investigations Unit and pharmacy audit, shares how going beyond traditional FWA models helps enhance safety, and why that’s more important than ever

Jessica Johnson, clinical consultant at Prime/Magellan Rx’s special investigations unit, shares how to help lower the risk of drug misuse.

Lassen, chief clinical officer at Prime Therapeutics/Magellan Rx, shares insights on GLP-1 weight-loss drugs and evidence-based approaches to providing the kind of care we’d want for our loved ones.

September 29, 2026 publications Clinical Insights: Alzheimer’s in Focus Evidence, Answers and Perspectives Across an Evolving Alzheimer’s Landscape Prime Therapeutics’ Clinical insights is your...

The SIU promotes safety to prevent fraud, waste and abuse schemes

How Prime's SIU helps promote safety to prevent fraud, waste and abuse schemes

Join us and help reimagine pharmacy benefit management to provide the same care you would want for your loved ones. Check out our Careers page to see additional job listings, benefits and more....

2M HighTouchRx® has contributed to more than $200 million in savings across commercial and Medicare plans since 2022. Prime serves approximately 6 million Floridians. IntegratedRx® connects...

Special Investigations Unit helps promote safety to prevent fraud, waste and abuse schemes

Jessica Johnson, clinical consultant, shares how the Special Investigations Unit at Prime helps identify cases of fraud

cover image Evidence, Answers and Perspectives Across an Evolving Alzheimer’s Landscape Prime Therapeutics /clinical-insights-alzheimers-in-focus Prime Therapeutics’ Clinical insights is your...

What to expect at Academy of Managed Care Pharmacy (AMCP) Nexus 2023

Managed Healthcare Executive: Use of GLP-1 drugs and weight-loss care management programs need to focus on adherence and persistency for better health outcomes, suggests Prime...

George Van Antwerp breaks down how Prime is poised to drive affordability in drug pricing

Fraud, waste and abuse protection We offer a variety of clinically backed programs and solutions to integrate care and improve the member experience. Home Our solutions Drug access Connect members...

Anonymous reporting Report a compliance concern or suspected fraud, waste or abuse anonymously, by contacting Prime’s 24-hour anonymous compliance hotline: 800.474.8651...

Experts share insights in “The evolving strategies for managing nAMD and DME” session at Las Vegas event

Over time, technology has significantly contributed to health care advancements. Some of these enhancements are now considered routine components of care and include electronic health record,...

In this episode, you’ll learn about advancements in the pharmacy profession and how pharmacists are working to help care for patients and make health care better and more accessible

For the first time, Prime Therapeutics hosted the AMCP Nexus specialty keynote, addressing trends in cell and gene therapy and rare disease and immunology categories

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Prime's Sneha Sharma and Michael Szatkowski present “A beginner’s guide to decoding cell and gene therapy” educational session at event in Las Vegas, Nevada

Nick Friedlander, clinical program pharmacist at Prime, shares more about two research studies that convey the impact of one cost-savings solution.

Nicole Grevenitz, director of clinical account services, shares more from the research study “Promoting Health Equity Through Enhanced, Personalized Digital Outreach.”

Brooke Hunter, senior health outcomes scientist at Prime, shares more about the study “Methodological Framework for Propensity Adjusted Benchmarks for Pharmacy Key Performance Indicators”

With an established playbook for launching new union business, we ensure smooth transitions, clear communication and rapid implementation. Our Special Investigations Unit (SIU) uses advanced...

Prime's Madhavi Manduru-Rao presents “Navigating the Final Chapter: What’s Next for Your Managed Care Pharmacy Career Journey – Opportunity for Rewirement vs. Retirement”

Prime’s Sean Wuest and Highmark Health’s Lisanne Holley present educational session at Last Vegas event

Scott Leslie, director of health outcomes, shares more about the study “Real-World Case Series Study of Spinal Muscular Atrophy Pediatric Patients Treated With Onasemnogene Abeparvovec (Zolgensma)”

Ben Urick, senior director of health outcomes, and Landon Marshall, health outcomes research principal, share more about their educational session and research poster on GLP-1s

Lead author Kristin Brown-Gentry shares insights from the study “Unlocking Public Health Insights: Leveraging Air Quality Data to Develop Social Determinants of Health Metrics Linked to Asthma...

Every pharmacy in Prime’s network must do the following to meet compliance requirements: Training: Provide CMS’ “Medicare Parts C and D General Compliance (April 2020)” and “Medicare Fraud & Abuse:...

Jared Scripture, health outcomes scientist, shares more about the study “Leveraging Publicly Available SDOH Measures to Segment Members and Quantify Differences in Diabetic Medication Adherence: A...

Lead authors Erin Ventura and Alina Liang share more about the study “Evaluating the 10-Year Impact of an Immunoglobulin Utilization Management and Dose Optimization Program in the Managed Care...

Important Website Notification of Data Security Incident As part of our commitment to transparency, we are sharing a recent vendor security incident about unauthorized access to Prime’s contact...

Lead author David Eckwright shares more about the study “Real-World Extended Dosing Assessment for Eye(s) new to Faricimab-svoa Therapy.”

Empowering client, providers and members Building a trusted, transparent PBM Tab 1 2021 – Current 2015 – 2020 2010 – 2014 1998 – 2009 Helping improve care, reducing cost through integration See our...

Jessica Johnson, clinical consultant at Prime's Special Investigations Unit, shares how to identify fake GLP-1s

NMPI: National Medicaid Pooling Initiative We negotiate the best price available from the pharmaceutical industry on behalf of our participating clients. View resources Services we offer Our...

Nationwide effort on Oct. 25 offers opportunity to safely dispose of unused or expired medications

Notice of privacy practices Effective Date: January 2026 THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE...

Zabrina Watkins Radical welcomeness “At Prime, our success is largely based on our team. Ensuring we create and maintain an environment that is positive, engaging and welcoming to all is a...

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publications As CAR T evolves, so does the site of care July 21, 2026 Author: Caroline Quinn, PharmD, BCOP For much of its commercial history, chimeric antigen receptor T-cell (CAR T) therapy has...

Effective Date: July 1, 2026 Introduction, scope, and purpose: Prime Therapeutics LLC and all of its operating units and subsidiaries (“Prime,” “we,” “our”) understands that the privacy of your...

publications Summer 2024 Prime Therapeutics Report June 11, 2024 The Prime Therapeutics Report is your source for innovative managed care strategies, trends and updates. This issue’s cover story...