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Hard-earned insights that help drug manufacturers achieve their growth, compliance, and profitability objectivesChargeback Processing — Best Practices to Avoid Revenue Leakage & Risk
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...
Medicaid Rebate Liability Forecasting After Unwinding, Puerto Rico Inclusion
MEDICAID REBATE LIABILITY FORECASTING AFTER UNWINDING, PUERTO RICO INCLUSIONFor pharmaceutical manufacturers accruing for Medicaid rebate liabilities, new updates on continuous enrollment unwinding from the COVID Public Health Emergency and the addition of Puerto Rico...
Update – Inflation Reduction Act Rebate Provisions for Pharma Manufacturers
Update – Inflation Reduction Act Rebate Provisions for Pharma ManufacturersInflation Reduction Act – new updates! On August 16th, 2022, the Inflation Reduction Act (IRA) of 2022 was signed into law, creating potential impacts for drug manufacturers in the way of...
CMS Enforcement for ASP in Medicare Part B
CMS Enforcement of Average Sales Price (ASP) Submissions for all Medicare Part B Eligible Pharmaceuticals and BiopharmaceuticalsRecently, CMS has been sending letters to pharma and biopharma manufacturers (with and without MDRP agreements) indicating that they...
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,...
Inflation Reduction Act Likely To Have A Negative Financial Impact On Many Drug Manufacturers
Inflation Reduction Act Likely to Have a Negative Financial Impact On Many Drug ManufacturerOn August 16, 2022, the Inflation Reduction Act of 2022 was signed into law with provisions aimed at lowering drug, health care and energy costs for consumers in the United...
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...