- of The Medicare Prescription Payment Plan – M3P – applies to all plan sponsors and fundamentally changes workflows for pharmacies, pharmacy benefit managers (PBMs), and health plans.
new york, March 27, 2024 /PRNewswire/ — Capital Rx, a full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA), advances our nation’s healthcare infrastructure to improve drug price visibility and patient outcomes. We provide standalone, turnkey, end-to-end Medicare Part D Medicare Prescription Payment Plan (M3P) solutions to the market for health plans, payers, and PBMs. This new solution facilitates support for plan members’ ability to pay for medications as required by the Centers for Medicare and Medicaid Services. (CMS) Guidance.
Capital Rx’s M3P Solution in JUDI®is a next-generation enterprise healthcare platform that includes billing and reporting, claims adjudication, cost sharing and tracking, program calculations, payment options, and new pharmacy notifications needed to meet CMS requirements for M3P, all in one feature. It offers a set of features covered in system. This effectively addresses some of the challenges faced by Part D sponsors. This includes the need for increased staffing in call centers, billing and registration, accounting, pharmacy operations, and other areas of the organization affected by the new requirements.
Additionally, Capital Rx’s M3P solution is built on the latest Medicare reporting, providing the data needed for Prescription Drug Events (PDEs) and Explanations of Benefits (EOBs) to ensure program compliance and Supports CMS data submission requirements.
Latest healthcare technology helps address prescription drug affordability in the US
It’s no secret that CMS is taking steps to help Americans enrolled in government programs get the health care they need. Unfortunately, a significant portion of older Americans (more than 25%) find it at least “somewhat difficult” to buy prescription drugs. The situation is even worse for black and Hispanic Americans and households with lower incomes. To address this, in addition to capping out-of-pocket drug costs for seniors, Medicare enrollees enrolled in the Part D program will be given the ability to pay for prescription drugs throughout the plan year. This reduces the burden of expensive upfront payments at medical institutions.Pharmacy counter begins January 1, 2025thanks to M3P.
“JUDI allows our clients to confidently support all M3Ps with relative ease,” he said. AJ Loiacono, Capital Rx Co-Founder and CEO. “This is a new program of its kind that JUDI has customized to meet our requirements. The unparalleled flexibility, efficiency, transparency and accuracy of our latest technology comes into play in these situations. We look forward to helping health plans smoothly implement this program, which allows older adults to afford the medications they need with more flexible payment terms. ”
“When new programs are announced, our goal is to act quickly to establish the most efficient workflows and processes to meet regulatory requirements. We can do that for you.” jason barrettVice President of Government Program Operations, Capital Rx. “I have yet to see any new program announcements or requirements at the state or national level that we at JUDI cannot address.”
For more information about Capital Rx’s M3P solutions and answers to frequently asked questions, please visit our website.
About Capital Rx
Capital Rx is a full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA) that advances our nation’s electronic health infrastructure to improve drug price visibility and patient outcomes.As a Certified B Corp™Capital Rx is fulfilling its mission through the implementation of JUDI.®the company’s cloud-native enterprise health platform, and single ledger model™, increasing visibility and reducing drug price volatility. JUDI connects every aspect of the pharmacy ecosystem into his one efficient, scalable platform, serving millions of members across Medicare, Medicaid, and commercial plans. Capital Rx works with clients to reimagine pharmacy benefit management and rebuild trust in health care. For more information, please visit capitalrx.com.
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SOURCE Capital Rx
