“Our pharmacy team has developed reimbursement strategies that have shifted how pharmacies across the nation are reimbursed. This method is more accurate, reliable and transparent than any other solution in the market.” Kris Knerr, CPA, member and Partner-in-Charge of the Pharmacy Team
The pharmacy engagement team is made up of pharmacists, accountants and analysts who have a clear and thorough understanding of the complex pharmacy reimbursement landscape. We have worked with state Medicaid programs to establish levels of pharmacy reimbursement for over four decades. We have pioneered innovative pharmacy reimbursement strategies that are based on actual drug acquisition costs as well as the true costs pharmacies experience when dispensing prescriptions. This important work has led to a major shift in the pharmacy reimbursement space. We have partnered with CMS, the head of Medicare and Medicaid, to move the acquisition-based reimbursement methodology to the national level. This has been very successful and has opened doors for our firm to grow and expand our services in many more state programs.
We provide complex data analysis, fiscal modeling and rate setting services that require a highly skilled staff. Our clients depend on our sound advice to assist in the planning and implementation of programs that help to maintain their pharmacy benefit.
Our pharmacy reimbursement rate setting work establishes the amount pharmacies should be reimbursed when dispensing prescriptions to Medicaid recipients. We also consult with our state clients on how to plan, implement and maintain a pharmacy reimbursement methodology that is fiscally sound while also providing a transparent, reliable and accurate reimbursement formula. We also provide our clients with sophisticated fiscal models that allow for decision making on complex issues such as appropriate levels of provider reimbursement, 340B drug pricing program, and the drug rebate program.
Our work has led to substantial program savings for our clients and has also created a shift in how pharmacies are reimbursed across the nation. We believe that with our assistance, state Medicaid programs can create a solid foundation for pharmacy reimbursement.
The pharmacy team is excited with the shift to acquisition cost based pricing. We have worked hard to develop a reputation of providing reimbursement solutions and recommendations that have lead to meaningful program changes. We will continue to work hard to provide expert consultation to our state clients that will allow them to meet their program objectives.