The monthly read on what's shifting.

POS reform moved the fees. PBMs moved the goalposts. Here’s what shifted, which dispensing categories carry the highest exposure, and the documentation that protects your margins.

Specialty pharmacy carve-outs, narrow network inclusion strategy, and gold carding — what the reform helped and what it missed.

Electronic PA reform left a compliance gap pharmacies are absorbing alone. Medicaid unwinding AR damage is landing mid-2026. PBM audit defense priorities have shifted. Three things that changed — and what to do now.

2027 benefit design season is happening now. DIR math didn't change — the timing did. PBM audit targeting shifted from reactive to proactive. Three things to act on this month.

PBM audits are targeted, not random. DIR fees adapted rather than disappeared. “Transparent PBM” is a marketing term. Three things shifting right now — and what to do about each.