Monday, August 19, 2013

Understand and Comply with State Processes, Operations and Requirements

We're pleased to announce a new content partnership Huron Life Sciences. Each week they'll be sharing their latest insights on the Medicaid Rebate Process, Government Pricing & much more. Want to join them at the Medicaid Drug Rebate Program 2013 taking place September 9-11 in Chicago, IL? Save 15% when you mention XP1858BLOG to register.  Today’s Author: Sam Woronoff 

The Final Rule release is delayed yet again. However, this gives an excellent opportunity to “brush up” on the overall Government Pricing knowledge, perform last minute GP housekeeping, and tighten up the internal GP compliance operations, paying specific attention to some of the often overlooked areas such as the State reporting, Medicaid Rebate Processing, Dispute Resolution, supplemental/SPAP programs, and other concerns that the states' may have. This year's MDRP conference offers various tracks to fill in any GP knowledge gaps, especially in the matters of states.

Medicaid rebate operations on the states’ side have undergone many changes in the previous year. With many of the states transferring their operations such as data processing, invoicing, disputes and payment processing to a Third Party Administrator, manufacturers face challenges of keeping up with new information and sometimes modifying their systems to meet the TPA’s administrative requirements. The “States Spotlight: How States Are Currently Processing Rebates and Intend to Move Forward into 2014”session will provide updates on the current changes, as well as give important insights into the states’ future plans to develop and implement industry standard claims level detail in order to improve efficiency, reduce administrative costs, reduce dollars tied up in disputes, and provide a compliance platform.

Another hot topic is the Texas Drug Vendor Program. Texas has enforced even more regulation on its reporting requirements. In addition to the quarterly AMP and BP price reporting, as of March 2013, Texas requires a reporting of the monthly price changes to the Wholesaler, Chain Pharmacy, Retail Pharmacy, and LTC pharmacy class of trade for the drugs sold to these customers in Texas. Meeting these requirements is a big challenge for many manufacturers and creates more strain on budgets and resources. Jansen Pharmaceutical will be sharing valuable knowledge and findings gained from their experiences with implementing their Texas calculation and reporting program.

States are becoming bigger players in the GP arena and are demanding compliance from manufacturers. Everyone benefits from being better informed so that they can build a robust GP operation and be malleable to the ever-changing GP world. Huron Life Sciences will be presenting on this very subject as well as providing live blogs for the main conference and all tracks.

Looking forward to seeing you there!

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