Master the Margin – Pharmacy Influencer Series: Trends in Reimbursement Solutions
Frier Levitt Life Sciences Partner, Jesse C. Dresser, Esq. participated in a Master the Margin webinar with Ollin Sykes, CPA and Scotty Sykes, CPA, CFP® , both of Sykes & Company, P.A. to discuss recent trends in reimbursement methodologies and the legal tools that exist to assist pharmacies in pushing back against changing PBM and payor reimbursement rates.
In this engaging overview, you will:
- Differentiate the different reimbursement and pricing methodologies used by PBMs when adjudicating pharmacy claims, including Average Wholesale Price (AWP), Average Sales Price (ASP), Maximum Allowable Cost (MAC), Generic Effective Rate (GER), Brand Effective Rate (BER), Direct and Indirect Remuneration (DIR), and more
- Understand the different laws that apply to PBMs regarding reimbursement rates, and how it impacts drug pricing
- Identify strategies pharmacies can use to ensure lawful and appropriate reimbursement rates under the law, as well as the status of various pending actions/litigations