The Pricing Group is a boutique consulting firm specializing in Government Pricing (GP). We guide new and established pharmaceutical manufacturers through the requirements of Medicaid, Medicare, the Federal Supply Schedule, and the PHS/340B program.
Meet Our Team
We provide comprehensive Government Pricing (GP) services for new and established manufacturers. This includes entering the necessary contracts and the ongoing requirements for participation in the federal healthcare programs (Medicaid, Medicare, PHS/340B, VA/FSS, and TRICARE).
Managing the invoice process for more than 300 Medicaid plans is no small feat. We remove this burden by providing claims validation, processing, and payment generation of rebates paid to Medicaid, TRICARE, Medicare (Part D and Inflation Rebates), commercial plans, and PBMs.
We recognize the importance for manufacturers to find the appropriate balance between commercial and government business. We guide our clients in understanding and implementing effective pricing strategies while complying with the requirements of government healthcare programs.
We conduct audits and assessments for manufacturers who participate in the Federal Healthcare Programs. We assist our clients in determining the service most appropriate depending on the supporting documentation in place.
R-Max is built for flexibility, intelligence, and full regulatory compliance. It's tailored to your products, distribution channels, and contracts while streamlining your GP reporting requirements. Created by industry experts, it ensures accuracy, mitigates risk, and gives confidence as you submit and certify calculations. Ready to learn more? Contact us today.
Contact UsThe Pricing Group holds a depth of knowledge and a strategic point of view that cannot be found at other consulting firms.
We understand the complexity of today’s highly regulated environment, and we assist our clients in managing the associated risks while ensuring consistency and accuracy in their GP calculations and submissions.
Our services are designed to not only ensure compliance, but to also give our clients the confidence to certify calculations without concern or doubts regarding the integrity of the information submitted to the government.
Welcome to The Price Point, where we share our insights on the complicated world of Government Pricing and the pharmaceutical industry. Whether you’re curious about the latest regulatory changes or just looking to expand your GP knowledge, you’ll find discerning analyses and thought-provoking discussions here.
Jun 26, 2026
Your Government Pricing reports may reconcile perfectly—but could you explain and defend every number if an auditor asked? This article explores why understanding the methodologies, assumptions, and controls behind your GP calculations is just as...
Jun 4, 2026
Use June's traditionally quieter stretch to get ahead of the updated ASP reporting requirements that will take effect with the Q2 submission due July 30.
May 19, 2026
Our team brings deep expertise in regulatory interpretation, methodology design, and audit readiness, helping you navigate one of the most complex areas of pharmaceutical finance with clarity and confidence.
May 8, 2026
On April 2, 2026, a proclamation was issued imposing tariffs on imports of pharmaceuticals, with staggered effective dates, July 31, 2026, for certain large companies and September 29, 2026, for all others.
Apr 8, 2026
CMS released instructions and forms associated with the new Average Sales Price (ASP) reporting and certification obligations, effective with the Q1 2026 submission.
Apr 2, 2026
While activity in the Government Pricing world seems to have slowed slightly, there are still several important upcoming deadlines and items to keep on your radar.
Feb 20, 2026
Well-drafted, current policies demonstrate good-faith compliance efforts and can be critical in defending against audits, government inquiries, and enforcement actions.
Feb 9, 2026
By now, your Medicaid, PHS/340B, and Medicare calculations for Q4/December 2025 should be wrapped up, which means it’s about time to get started on your next monthly calculations!
Jan 5, 2026
Happy New Year! A new year often brings new ideas, connections, and opportunities. As you may have seen from our recent announcement, Lisa Clayton has stepped into the role of Executive Director, and Katie Lapins has transitioned to Senior Advisor.
Jan 1, 2026
As we begin the new year, we are pleased to announce important leadership updates within The Pricing Group, effective today.
Dec 4, 2025
For many in GP, it’s “the most wonderful time of the year!" Here are a few upcoming GP-related activities and deadlines to note.
Nov 4, 2025
If you’re like us at The Pricing Group, October has proven to be as busy as we expected. Read more about upcoming GP deadlines!
Oct 3, 2025
October marks the start of an especially busy period in Government Pricing. Here are a few upcoming GP-related activities and deadlines to note.
Sep 3, 2025
As we shift into September, your Q2 Medicaid invoices should have started coming in. Learn more about other upcoming GP deadlines and activities of note.
Jul 30, 2025
July has been a busy month for The Pricing Group, and if you’re like us, you’ve just wrapped up most things for your Q2 reporting. Read more about upcoming GP deadlines!
Jul 7, 2025
We hope you had a happy and safe Fourth of July celebration! We have a few noteworthy topics, reminders, and deadlines to mention. Also, Crossroads 2025 is right around the corner!
Jun 2, 2025
As expected, the Department of Health and Human Services (HHS) submitted their PHS/340B Rebate Proposal to the Office of Management and Budget (OMB) for review.
May 2, 2025
Happy May! Did you know that May Day started out as a celebration of spring with the resurrection of nature after the long winter months? That feels appropriate after the winter many of us experienced! Here are some upcoming GP-related deadlines.
Apr 8, 2025
April is here, and spring has sprung (or is on its way!) for many of us. Here are just a few upcoming GP-related activities and deadlines to note.
Mar 4, 2025
The more things change, the more they stay the same. Even though it’s the beginning of a new year, there’s a new administration in the White House, and there’s still a lot going on in Government Pricing.
Feb 5, 2025
By now, your Q4 and December 2024 calculations should be about wrapped up! If you are in the Government Pricing (GP) space, that means it’s about time to get started on your next monthly calculations.
Jan 9, 2025
A new year often brings new ideas, connections, and opportunities. At The Pricing Group, we’re excited about 2025 and the ever-changing world of Government Pricing.
Oct 1, 2024
On September 20, 2024, CMS issued the Misclassification of Drugs, Program Administration and Program Integrity Updates Under the Medicaid Drug Rebate Program Final Rule (Final Rule) that is related to the Proposed Rule issued May 24, 2023.
May 17, 2024
Unsure if you’re ready for a Government Pricing audit? An assessment might be a better fit for your company. Read the differences below, and let us know if you have any additional questions. We’d be happy to point you in the right direction!
Apr 22, 2024
On April 19, 2024, the Health Resources and Services Administration (HRSA) issued a Final Rule with regards to the administrative dispute resolution process (ADR) between manufacturers and Covered Entities (CEs) who participate in the 340B Program.
Nov 11, 2023
It’s a busy time in Government Pricing! Late last week, we had the decision from the United States Court of Appeals for the Fourth Circuit regarding the Patient definition for purposes of the 340B Program.