CMS-Required Outcome
The system has the capability to support cost savings by capturing, storing, and transferring data to the payment process system to generate invoices of participating drug manufacturers within 60 days of the end of each quarter.
- Percentage Rebate Invoiced per Dollar (Note if invoice period is behind the actual reporting period).
- Issue timely invoicing within established parameters (+/- 5 days).
- Section 1927 of the SSA
- 42 CFR 447.520
- Section 1927(b)(2) of the SSA
- 42 CFR 447.511
How states write outcomes in this module
The Single Pharmacy Benefit Manager (SPBM) module will provide accurate and timely processing of pharmacy claims utilizing fully transparent pricing and payment methodologies as determined by the Ohio Department of Medicaid.
The Single Pharmacy Benefit Manager (SPBM) module will improve the accuracy and timeliness of the acquisitions and integration of pharmacy claims encounter data.
The Single Pharmacy Benefit Manager (SPBM) module will reduce the overall benefits and administrative costs of the Ohio Medicaid pharmacy program.