The reporting and requirements of Medicare Part D grow every year, adding significant burden and forcing organizations to spend notable resources managing these processes.
Our PBM, Pharmastar, can help alleviate these burdens, providing full-service pharmacy benefit management services to help ensure your staff spend time providing care to beneficiaries, not on pharmacy administration. Our PBM tools and depth of expertise drive results, without engaging in business practices that inflate costs or hinder access to medications.
As the exclusive PBM endorsed by the National PACE Association, Pharmastar provides solutions designed to meet the unique needs of PACE programs.
Pharmastar offers customized solutions and plan designs to maximize prescription benefits. As our partner, you choose the programs to implement and the level of involvement that best suits your organizational needs. We will provide meaningful, clinically appropriate guidance and recommendations based on your specific population requirements.
The best PBMs are not always the biggest; they are the ones that make prescription drug costs easier to manage and understand. We stand apart from the largest PBMs with our unique model, which is built on key differentiators, including:
Fully transparent model with no pharmacy fees or spread pricing
Complex administrative program expertise
Transparent pricing
Proven outcomes, including total cost of care savings
Integrated PBM and pharmacy services
Personalized medication regimens
Drug management program for opioids
Our services are flexible, provide high-touch service, and enable you to achieve cost savings.
The reporting requirements for Part D are multifaceted. To streamline workflow, we are able to create all of the CMS required reports, monitoring deadlines and providing organizations with all of the information needed for a successful submission. Our partners have access to regular utilization and financial reports, and we work with programs to develop ad-hoc reports that suit the specific needs of each organization. Plus, all Pharmastar partners have full access to the raw data available through any and all reports.
Successful prescription drug event (PDE) submissions are critical to maintaining financial health and compliance requirements. With increasing CMS requirements for PDEs, Pharmastar helps organizations submit these filings. We submit PDE reports twice monthly to CMS on our partners’ behalf, and our partners receive detailed monthly reports about these submissions along with yearly filing attestation.
We quickly and effectively accomplish claims processing needs for partners.
Pharmastar’s Medicare Part D rebate processing program involves close collaboration with drug manufacturers, cutting unneeded steps and providing better oversight and a clearer view into rebate claims. Our advanced technology provides plans with more timely rebate payment information and better rebate reporting to help monitor and improve accuracy. By eliminating multiple levels in the pharmacy claim, we can provide the precise data needed to help make audits easier.
When a program undergoes a CMS audit, there is an abundance of policies and procedures that are under tight scrutiny. Programs who partner with Pharmastar will find reassurance and guidance through the expertise and attention of our specialists. Partnering with a fully engaged PBM like Pharmastar can be the difference between successful audits and discovering that your program could owe thousands of dollars in unplanned CMS audit discoveries.
If you want to know more about how AnewHealth is transforming pharmacy’s impact on patient health or are interested in working together, get in touch!
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