Manufacturer Assistance Payments $ Needed FIRST in Drug Cost Reporting

As the marketplace is scrambling to complete Drug and Healthcare Cost Reporting for the very first time, PBMs and TPAs are discovering that BEFORE they can complete their end of the reporting they FIRST must have the amounts received by the Plan for Manufacturers Assistance Program payments. 

This is just beginning to create quite a bottle neck and here is why.  Think of this like ‘Data Dominos’ . . .

  • The TPA must have files D3-D8 complete by the PBM before they can complete their side of the reporting.  Therefore the TPA is ‘waiting’ on the PBM.
  • The PBM must have data regarding Manufacturers Assistance program payments before they can create their end of the reporting.  Therefore they are ‘waiting’ on these vendors to provide those amounts.

See the problem? 

And it gets worse because most of the organizations that offer services to help plan sponsors capture manufacturers assistance payments are unaware that they are the bottleneck.  In fact, as we have questions the marketplace we have found that most (or all) of these vendors have not even started to look into what is required from them regarding this new reporting.