RxParadigm

What does carving out pharmacy benefits from managed Medicaid (MCO) to fee for service (FFS) mean for Covered Entities?? Some states, like New York, have carved out pharmacy benefits from managed care plans (MCO), opting instead for a fee for service (FFS) model.?As reported in the KFF Medicaid Budget Survey 2024-2025, 8 states?nationwide have models to carve out pharmacy benefits and move into a FFS model.?Read more to learn what this means for CEs and how a neutral 340B Clearinghouse is the way forward. #FeeForService #ManagedMedicaid #340BClearinghouse #RxParadigm

HHS Fights Sanofi’s FOIA Lawsuit Seeking Extensive 340B Contract Pharmacy Records - https://lnkd.in/eY_NSmH2 The federal government is pushing back against Sanofi’s lawsuit demanding the release of up to 7,500 records of 340B contract [...] #340B

Exciting news! RxParadigm has announced a strategic partnership with PrairieStar Health Center to launch Tungsten + PLUS?, a neutral 340B clearinghouse platform. This innovative solution is designed to certify 340B claims, prevent duplicate discounts, and ensure compliance with state and federal regulations. With this collaboration, PrairieStar Health Center becomes a trailblazer as one of the first health centers to adopt a neutral clearinghouse solution, setting a nationwide precedent for transparency in 340B program management. Read more: https://lnkd.in/exa8AuGC #RxParadigm #PrairieStarHealthCenter #TungstenPLUS #340BClearinghouse

Check out part three of RxParadigm’s three-part series on commercial rebates: Clearinghouse as The Way Forward. In the expanding landscape of the 340B Program, commercial rebates have grown to be a major driver of manufacturer led actions to restrict the 340B program. ?According to Johnson and Johnson’s 2023 transparency report, of the $42.8 Billion dollars paid by the manufacturer in rebates, discounts and fees, $13.4 Billion were paid in commercial rebates. In comparison, $6.0 Billion were paid to 340B Program, and $4.3 Billion paid to Medicaid. Johnson and Johnson is just one example of the many manufacturers whose largest discount and rebate spend factor is commercial rebates. ?Understanding how commercial rebates work within the 340B Program is crucial for Covered Entities to tackle the ever-growing trend of restrictions and build a sustainable 340B program solution. In Part 3, we explore the role of a neutral 340B Clearinghouse to amend the commercial rebate problem. #RxParadigm #CommercialRebates #340BClearinghouse

Exciting news! RxParadigm is presenting at the PBM Contracting Summit on Dec 10-11 in Chicago. Our session will address key topics including the core issue of 340B double payments, an analysis of why efforts to transition the 340B program to a rebate model have faced significant resistance from covered entities and HRSA, and the role of a 340B clearinghouse in ensuring compliance with IRA regulations. We'll also explore the emergence of a "340B claims clean drug rebate" strategy in the commercial market and its potential benefits. Looking forward to sharing insights and discussing solutions to these pressing issues! RxParadigm is thrilled to be sponsoring the PBM Contracting Summit. To join us, visit https://lnkd.in/eYEbw7AD . You can also save 10% using our code: 24RxP10. #340BProgram #HealthPolicy #PBMContractingSummit #RxParadigm #340BClearinghouse

Exciting news! RxParadigm is presenting at the PBM Contracting Summit on Dec 10-11 in Chicago. Our session will address key topics including the core issue of 340B double payments, an analysis of why efforts to transition the 340B program to a rebate model have faced significant resistance from covered entities and HRSA, and the role of a 340B clearinghouse in ensuring compliance with IRA regulations. We'll also explore the emergence of a "340B claims clean drug rebate" strategy in the commercial market and its potential benefits. Looking forward to sharing insights and discussing solutions to these pressing issues! RxParadigm is thrilled to be sponsoring the PBM Contracting Summit. To join us, visit https://lnkd.in/eYEbw7AD . You can also save 10% using our code: 24RxP10. #340BProgram #HealthPolicy #PBMContractingSummit #RxParadigm #340BClearinghouse

Happy Veterans Day from RxParadigm! #VeteransDay #Holiday #RxParadigm

Arkansas Officials, Providers Urge Supreme Court to Deny PhRMA’s Appeal to Overturn 340B Contract Pharmacy Access Law - https://lnkd.in/eDDW7AYN Arkansas state officials and providers are urging the U.S. Supreme Court not to take up a drug industry trade group’s [...] #340B

This is part two of RxParadigm’s three-part series on commercial rebates. In the expanding landscape of the 340B Program, commercial rebates have grown to be a major driver of manufacturer led actions to restrict the 340B program. According to Johnson and Johnson’s 2023 transparency report, of the $42.8 Billion dollars paid by the manufacturer in rebates, discounts and fees, $13.4 Billion were paid in commercial rebates. In comparison, $6.0 Billion were paid to 340B Program, and $4.3 Billion? paid to Medicaid. Johnson and Johnson is just one example of the many manufacturers whose largest spend factor is commercial rebates. Understanding how commercial rebates work within the 340B Program is crucial for Covered Entities to tackle the ever-growing trend of restrictions and build a sustainable 340B program solution. #CommercialRebates #340BProgram #RxParadigm #340BClearinghouse

Happy Halloween from all of us at RxParadigm!