Parishes, school boards, and municipalities across Louisiana self-fund their employee health plans — and pay whatever the pharmacy middleman bills. We re-price every claim against the federal government's own drug-cost benchmark and show you, line by line, what your plan actually should have paid. The review costs you nothing.
Louisiana SEBD & LED Hudson Initiative certified (2026) · Registered Louisiana state vendor
Every figure above is from a published government report or settlement. The same benchmark-based method those auditors used is the one we apply to your plan.
This applies a leakage rate a state auditor actually documented — the Ohio Auditor of State's landmark claims-level pharmacy audit — to a plan of your size. It's a model, not a finding. The point is the size of the question mark sitting in your budget, and that answering it costs you nothing.
Leave blank and we model it at a deliberately conservative $3,000 per covered employee per year. Your plan's actual pharmacy figure — the number on your TPA or CFO report — tightens this instantly.
Enter your covered-employee count — or your annual pharmacy spend — to run the model.
That range is what a forensic re-pricing of your claims would either surface — or rule out. Either answer is worth having, and the review costs your plan nothing.
We analyze your plan's published financials, contracts, and — at your election — claims data your plan is entitled to request from its own vendors. Every drug claim is re-priced against NADAC, the federal survey of what pharmacies actually pay for drugs.
You receive a written findings summary — what was overpaid, where, and the statutes that apply — built for your board and your own attorney. We provide forensic data analysis, not legal advice; every decision stays with you and your counsel.
If you choose to act on the findings, we support your team through it. The review itself costs nothing, and any engagement beyond it is scoped and priced with your counsel before it begins — structured to comply with Louisiana public-contract law. No surprises, in either direction.
Louisiana banned pharmacy "spread pricing" and mandated 100% pass-through of drug-maker rebates to plans — with enforcement provisions taking effect January 1, 2027. Money kept from your plan in ways the state has now outlawed is exactly what a forensic review surfaces.
Louisiana's Department of Insurance declared that pharmacy reimbursement below the federal acquisition-cost benchmark plus $9.00 is per se not fair and reasonable — a regulator-endorsed version of the exact benchmark we audit against.
Federal law now prohibits contract clauses that block a plan from seeing its own claims data — including "once a year only" audit limits. Your plan is entitled to the data that proves what it paid. We help you use that right.
Municipal Risk Forensics helps public employers strengthen fiduciary oversight of their employee health plans — by identifying financial leakage, improving transparency, and providing independent analysis that supports responsible stewardship of taxpayer resources. With increasing scrutiny around healthcare costs and fiduciary accountability, our goal is to help organizations uncover savings opportunities while strengthening governance and decision-making.
We are an independent forensic audit firm built for one client: the self-funded public employer. We take no commissions from insurers, brokers, or pharmacy benefit managers — the vendors we review — and we sell nothing but the analysis itself.
The firm is led by Isiah Edwards, a licensed life & health insurance professional with multi-state licensure and deep experience in how employer health plans are actually priced, sold, and serviced. That industry background is the point: we know where the money moves because we come from the rooms where it moves.
Our audit platform re-prices every pharmacy claim against public federal benchmarks, verifies every finding against the statute that makes it actionable, and produces work built to withstand scrutiny — by your board, your counsel, and the vendors themselves.
Municipal Risk Forensics is a forensic data-analysis firm, not a law firm, and provides no legal advice or legal services.
Our findings are factual and analytical. Any demand, claim, or recovery action based on them is the decision of your entity, acting through its own legal counsel.
Findings are delivered confidentially to you and your counsel.
Tell us the entity and roughly how many employees are on the plan. We'll tell you what a review would examine and what the public record already shows. No cost, no obligation, and you can stop at any time.