Medicaid Rebates manage the rebate calculation and invoice process to support the federal Medicaid Drug Rebate Program (MDRP) as well as state supplemental and state pharmaceutical assistance programs (SPAPs). Medicaid Rebates helps manufacturers protect revenues by identifying erroneous claims, managing disputes, and streamlining payments.

Medicaid represents a significant portion of the pharmaceutical industry’s revenues—upwards of 20% of overall pharmaceutical sales. Each prescription filled under Medicaid necessitates a rebate payment from the manufacturer to the state Medicaid agency. The high volumes of prescriptions, combined with a rebate claim process that lacks automation, creates a situation of high revenue leakage for manufacturers. Medicaid Rebates helps manufacturers to recover upwards of 4% of rebate claims by identifying erroneous claims and managing the dispute process.

KEY BENEFITS

• Reduced rebate exposure through error checking of Medicaid and supplemental invoices
• Streamlined, accurate calculation of unit rebate amounts for Medicaid and supplemental programs
• Identification of erroneous claims through variance and tolerance checks
• Reduced errors in payment processing