Payment Systems

Explore our payment system related resources tailored for managed care pharmacy. From claims processing and electronic prescribing to reimbursement systems and digital payment solutions, you'll find the latest industry insights, practical guides, and tools to streamline to better understand financial operations.

Payment Systems - Stock

AMCP Comments on Medicare Prescription Payment Plan: Draft Part Two Guidance

On Feb. 15, 2024, the Centers for Medicare and Medicaid Services (CMS) issued the Medicare Prescription Payment Plan: Draft Part Two Guidance and a Fact Sheet to provide guidance on education and outreach requirements for the Medicare Prescription Payment Plan (M3P), which was established by the Inflation Reduction Act (IRA). AMCP submitted comments in response to this Guidance on March 15, 2024.
Payment Systems
High-Investment-Medications Predictability Affordability and Accessibility Report - Cover

High-Investment Medications: Predictability, Affordability, and Accessibility

The FDA continues to approve novel therapies, but concerns arise due to the costs of certain treatments. To address this, the AMCP organized a forum to explore solutions. Stakeholders recognize the benefits of high-investment medications, but uptake of payment strategies has been slow. Gradual changes, education, and collaboration are essential to improve predictability, affordability, and accessibility for patients.
Drug Pricing, Managed Care Practice Issues, Drug Pricing, Payment Systems, Payment Systems, Drug Pricing
A prescription with money

Competitive Marketplace

AMCP believes that a health care delivery system that is based upon a competitive marketplace will provide greater value to patients and payers than a system that is one‐size‐fits‐all that relies on centralized governmental controls and regulatory mandates.
Payment Systems, Drug Pricing
A doctor and patient

The Best Price Requirement of the Medicaid Rebate Program

AMCP believes that to provide the greatest value to Americans who need prescription drugs, market forces must effectively ensure that manufacturers of similar drugs compete with one another to establish reasonable pricing levels and maintain consumer access to needed therapies. While government has a responsibility to protect consumers against anti-competitive activity, the government must not establish rules that have the unintended effect of undermining competition.
Payment Systems, Medicaid
Partnership Forum 2020

Helping Patients Anticipate and Manage Drug Costs

Partnership Forum: Participants considered the possible solutions for addressing rising costs and discussed challenges, practical steps for implementing point of sale rebates and other proposed solutions, and discussed how patient assistance programs and copay policies fit into the affordability equation. This forum will develop recommendations and possible solutions to improve price transparency, address the rising costs of medications, and help patient understand and manage drug cost.
Payment Systems
A prescription with money

Medication Cost-Share Offset Programs

AMCP recognizes that many patients today depend on high‐cost specialty medications that often do not have therapeutic alternatives. Medication cost-share offset programs provide out-of-pocket discounts or free product at the point of sale. AMCP is concerned that certain cost‐share offset programs may undermine formulary development and utilization management techniques and can also increase costs for health plans and, ultimately, patients themselves.
Payment Systems, Drug Pricing