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TRICAST, Inc. and Gorman Health Group Form Partnership to Fully Support Medicare Part D Oversight

TRICAST's Sentinel Effect Ensures Maximum Value from Pharmacy Programs

MILWAUKEE, March 25 /PRNewswire/ -- TRICAST, Inc. and Gorman Health Group announced a joint offering to Medicare Advantage and Part D plans to provide comprehensive drug benefit oversight. Gorman Health Group, the industry's leading Medicare managed care services firm, is integrating TRICAST's advanced pharmacy claims analysis tools with its compliance and financial services to offer a comprehensive assessment of the performance of Medicare Part D plans.

"TRICAST's tools provide full financial and operational analysis of pharmacy program activity," says Nathan Goldstein, Senior Vice President of Strategic Development for GHG. "TRICAST's unique reporting captures 100 percent of claim activity and provides claim-level drill down capability. With this offering, we are providing pharmacy plans an integrated look at financial, operational and compliance risk."

This combination of data and industry expertise will deliver a full array of new services to plans including:

  • Medicare Part D financial and plan management audits
  • Prescription Drug Event (PDE) financial reconciliation
  • Fraud, Waste and Abuse oversight
  • Pharmacy Benefits Management Request for Proposal (PBM RFP) evaluation and guidance
  • Centers for Medicare & Medicaid Services (CMS) bid submission tools and data applications

"The complexities of pharmacy benefits are captured by the complex pricing and management of this benefit," says Greg Rucinski, TRICAST President & CEO. "Our clients manage multimillion dollar drug spends and complex utilization issues. TRICAST's approach provides a sentinel effect of clarity, accountability and financial opportunity to ensure the maximum value is garnered from the program."

Fraud, waste and abuse in pharmacy programs drain resources and add unnecessarily to drug costs. "We continue to identify complex instances of FWA," Rucinski adds. "In certain cases we've been able to identify cases that are costing some plans more than $80,000 per member."


TRICAST, Inc., founded in Milwaukee in 1997, uses pharmaceutical and medical claims analysis for benchmarking, audits and risk analysis for health benefit plan sponsors. The company provides timely reporting on vendor performance, allowing opportunities for decisive responses for better program oversight, lowered plan costs and risk exposure. As a leading next-generation health information business, TRICAST offers programs, products and applications for the healthcare industry that assist risk entities controlling overall healthcare costs with a focus on pharmaceutical benefits. To learn more visit

About Gorman

Gorman Health Group, LLC (GHG) has provided expert strategic, operational, financial, and clinical services to the healthcare industry since 1996. Gorman experts deliver highly-practical professional services and training to the managed care and pharmaceutical industries, and are regularly quoted in the media and investment community for insights and analyses of the Medicare managed care market. Based in Washington, D.C., with ready access to key federal contacts and timely legislative and regulatory developments, GHG deploys a broad network of senior healthcare consultants nationally. Please visit

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Greg Rucinski

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