Software delivers price type builder capability.
November 8, 2006 -
Government Pricing and Medicaid Claims Processing applications include features that define, calculate, and report monthly Average Manufacturer Price (AMP) and Best Price (BP) calculations, maintain multiple baseline AMP pricelists, and define nominal sales in context of Average Sales Price and BP calculations. Validation and dispute capabilities manage Medicaid rebate claims across all federal and state programs, and software includes provisions for compliance with 2005 DRA.
(Archive News Story - Products mentioned in this Archive News Story may or may not be available from the manufacturer.)
|Original Press release |
Model N, Inc.
5000 Shoreline Ct.
South San Francisco, CA, 94080
Model N Announces DRA-Enhanced Release of Industry Leading Government Pricing and Medicaid Claims Processing Applications
Release Delivers Unique Price Type Builder Capability and Enhancements to Calculation, Price List Management, and Reporting
REDWOOD SHORES, Calif., Oct. 17 -- Model N, Inc., the leader in Revenue Management solutions, today announced the availability of enhanced versions of its Government Pricing and Medicaid Claims Processing applications incorporating key features designed to ensure compliance with the requirements of the Deficit Reduction Act of 2005 (DRA).
Representing the most significant change to the program since its inception in the early 1990s, the DRA provisions include a number of amendments to the law governing the Medicaid Drug Rebate program. The enhancements in the Model N Government Pricing Application include new features such as the ability to define, calculate and report monthly Average Manufacturer Price (AMP) and Best Price (BP) calculations, maintain multiple baseline AMP pricelists, exclude prompt pay discounts from AMP calculations, and define nominal sales in the context of Average Sales Price (ASP) and BP calculations. The unique integrated architecture built into the Model N Government Pricing and Medicaid Claims Processing applications not only ensures that all AMP and BP information is automatically available to Unit Rebate Amount (URA) calculations for current or historical calculations but also supports the powerful validation and dispute capabilities necessary to manage increased Medicaid rebate claims across all federal and state programs.
"While the implementation details of the DRA's wide-ranging statutory changes are still evolving, it is clear that manufacturers need to put in place systems and architectures with the flexibility to quickly adapt and incorporate the new regulations," said Ali Tore, Co-Founder and Senior Director, Product Management at Model N. "Model N was the first to release government pricing with ASP capabilities, and the company continues to demonstrate thought leadership in the industry by offering new capabilities such as the powerful Price Type Builder and the Medicaid Claims Validation Framework. These enhancements -- resulting from close collaboration with many of our current customers -- are aimed at providing the additional flexibility and rapid implementation needed to meet the coming challenges of DRA implementation and compliance."
Model N's Government Pricing and Medicaid Claims Processing solutions are built on an advanced technology platform that fully integrates the business processes and management of the data that drive Regulatory Compliance applications. In addition, these Regulatory Compliance applications are integrated into the commercial pricing, contracting and reimbursement solutions in the Model N Revenue Management Suite, providing a first-in-the- industry capability to align commercial and government business practices.
With this release, Model N continues to highlight the flexibility of its Regulatory Compliance solutions. Price Type Builder is a break-through enhancement in Government Pricing that allows manufacturers to model and implement their calculations and, with the new DRA enhancements, to address critical areas of methodology definition, calculation, analysis, and price management reporting across the entire government compliance area. Medicaid Program management capabilities allow manufacturers to easily amend their existing Medicaid programs and define new programs as their federal and state agreements evolve. The Medicaid application offers new levels of automation and adaptability to address the coming DRA changes through an adaptive validation architecture that allows manufacturers to perform multiple tests of reasonability as well as the flexibility to add new validations as needed.
"Implementation of the DRA requirements will underscore the need for a more integrated and comprehensive system for government price and rebates processing, one that supports a high level of automation that will be critical in a monthly submission environment," said Christopher Zant, a partner in Accenture's Health & Life Sciences practice.
"As illustrated by the passage of DRA this year, evolving federal and state pricing programs continue to transform the pharmaceutical industry, presenting manufacturers with increasingly complex challenges in managing compliance with government regulations," said Carlos Moriera, Practice Leader, Envision, a unit of IMS. "Combined with Model N's ability to integrate once disparate government pricing, contracts and rebates systems, we feel that the latest enhancements to Model N's Regulatory Compliance solutions will facilitate a manufacturers' ability to meet the DRA implementation deadlines. With the inherent adaptability of the solution, it will also provide a platform for our customers to implement the policies and processes that Envision helps them to develop to continue to stay ahead of the evolving legislation."
About Model N
Model N is the leader in Revenue Management solutions, offering an integrated suite of applications for pricing, contracts, compliance, rebates, fees and chargebacks optimized for the industry practices of life sciences, with the only integrated government pricing and Medicaid claims processing in the industry. Enabling the creation of a seamless, end-to-end process from pricing through settlements payment, Model N's uniquely integrated approach eliminates revenue leakage and delivers the visibility and controls needed to avoid the risks of non-compliance to government pricing and Sarbanes-Oxley regulations. Customers include Actelion Biopharmaceuticals; Boston Scientific; Bristol-Myers Squibb; CoTherix, Inc.; Gilead Sciences; MedImmune, Inc.; Medtronic, Inc.; Ortho-Clinical Diagnostics, a Johnson & Johnson company; and Pfizer, Inc. Model N is located in Redwood Shores, California. For additional information visit www.modeln.com.
Source: Model N, Inc.
Web site: http://www.modeln.com/