Chargeback Processing — Best Practices to Avoid Revenue Leakage & RiskChargeback processing, validation, and reconciliation are integral in maintaining a profitable business in the highly competitive U.S. pharmaceutical market. Profit margins are tight, especially...
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Top 3 Reasons Your AMP Changed
Top 3 Reasons Your AMP ChangedLarge variances in Average Manufacturer Price (AMP) values are a common source of inquiry for pharmaceutical manufacturers. Questions often arise when internal stakeholders are trying to understand an undesired rebate liability or a...
Medicaid – From a Simple Concept to an Operational Labyrinth
Medicaid – From a Simple Concept to an Operational LabyrinthThe federal government created Medicaid in 1965 as a public insurance program to expand existing federal support for healthcare services. It has since ballooned from its basic insurance program roots. Today,...
Understanding Class of Trade (COT) in the Pharmaceutical Industry
For pharmaceutical manufacturers, assigning Class of Trade designations to government pricing data can be a tedious exercise, however, it can have large implications on Medicaid rebate liabilities and present compliance risks if not managed correctly. Let’s take a...
Unit Rebate Amount Calculation For Medicaid
How to Calculate A Unit Rebate AmountFor people who regularly work in the pharmaceutical industry within the government pricing space, the question of how a URA is calculated may be one easily answered. For even the most seasoned pharma executives not exposed to...
Beware of the Many Operational Challenges of Medicaid Rebate Processing
Beware of the Many Operational Challenges of Medicaid Rebate ProcessingFor most pharmaceutical manufacturers, participation in the U.S. Federal Medicaid Drug Rebate Program (MDRP) is an important and necessary component of their commercialization...
Key Terms in Pharmaceutical Government Pricing
Key Terms in Pharmaceutical Government PricingPharmaceutical pricing can be a challenge to understand and a difficult landscape to navigate. There are multiple prices set for each individual National Drug Code (NDC) – some publicly available and some not. WAC, ASP,...
Why Have My Medicaid Rebate Payments and Processing Load Seen Such a Sharp Increase?
Why Have My Medicaid Rebate Payments and Processing Load Seen Such a Sharp Increase?A look at Medicaid enrollment and what the future may hold.The High Level Story The old adage “Those who choose to ignore history are doomed to repeat it” certainly holds true with...
PHS/340B Audit Survival Guide
PHS/340B Audit Survival GuideEven the most disciplined and compliant companies dread receiving a letter or an email informing them of an impending audit. Nobody likes being put under the microscope. It doesn’t take a great deal of imagination to know what it feels...