Happy New Year!
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.
Compliance is never optional, but flexibility should be.
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
Government Price Reporting
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).
Rebate Processing
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.
Government Price Consulting
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.
Audits & Assessments
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.
Meet the Team
Together with our partners at Artia Solutions, a leading national pharmaceutical consulting firm with a unique focus in Medicaid, The 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.
The Price Point
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.
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CMS Issues Long-Awaited Final Rule
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.
Audit vs. Assessment: Which is right for your company?
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!
Final Rule re. 340B Administrative Dispute Resolution Process
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.
OIG Compliance Program and Guidance re. Line Extensions
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.