Financial Implications to Government Pricing Programs

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 this year's Medicaid Drug Rebate Program taking place September 9-11 in Chicago, IL? Save 15% when you mention XP1858BLOG to register. Today’s Author:  Dana Zelig

Don’t let the name fool you, this year’s Medicaid Drug Rebate Summit isn’t just for your Government Pricing teams. In fact, IIR projects that only 20% of conference attendees will be in GP-specific job functions. The largest group of participants, with a whopping 37% of attendees, will represent Contracting functions. For those new to the space that might seem like a head-scratcher, but industry veterans know that contracting decisions have a huge impact on Government Programs participation. For this reason, IIR has dedicated one of its four conference tracks to discussing the Financial Implications to Government Pricing Programs.

Showcasing speakers from pharma companies, law firms, and industry service providers, the Financial Implications track discusses how to maximize profit while ensuring compliance and managing the government as a customer. The Gross to Net and Accrue and Forecast sessions will discuss the importance of tracking commercial transactions accurately and efficiently to provide visibility into GP liability. Put simply, $1 million in sales for the quarter does not mean $1 million in profit. Once the books are closed, GP and Medicaid teams still have to pay Medicaid rebates, process chargebacks to PHS entities, and identify Best Price implications driven by discounted contract prices. Contracting teams will have to assess the Financial Impact of Fee for Service vs. Managed Medicaid contracting relationships, to identify the agreements that meet the company’s sales targets, as well as its compliance requirements.

To wrap up the day, the Clarify the Branded Drug Fee Calculation session helps to explain why Finance and Accounts Payable departments are now tracking the various sales to Federal entities and the need to collaborate with the GP department to develop joint Policies and Procedures. If you’re a GP Manager who has been trying to explain this joint accountability to your counterpart in A/P, the final session, The Evolution of the GP Professional – Working Across the Organization, will recognize your herculean efforts to reach across the aisle. As you have probably already realized, your job isn’t just about managing vertically, it’s about managing horizontally throughout all divisions of your company. The Financial Implications track will give you the tools you need to explain to those in your organization that we are all “covered employees” who need to work together to share the responsibility, and the success.

Have questions throughout the Summit? Come visit us at the Huron Life Sciences booth, or find us between the sessions to share your thoughts – they might make it into our blogs!

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!