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FMCP-S Module 5: Trading Partners and Flow of Money in Managed Care Pharmacy
Module Description
The health care of the United States is both unique and complex. It has both state and federal oversight, and many stakeholders must work together to ensure the systems work to get medications to patients. This module also explains the “flow of money” between these stakeholders and how specific fees are calculated.
Target Audience
Pharmacists, Pharmacy Technicians, Managed Care Professionals
Learning Objectives
At the completion of this activity, participants should be able to:
- Identify the various stakeholders involved with the prescription drug benefit.
- Explain how managed care organizations determine pharmacy reimbursement for drug products and associated dispensing fees.
Faculty:
Joseph DiBiase Jr., CPhT
Director, Clinical Pharmacy Operations, Medicare Part D
Magellan Rx Management
Fred Goldstein
President and Founder
Accountable Health, LLC
Tracy McDowd, PharmD, FAMCP
Manager, Clinical Pharmacy
BlueCross BlueShield of Tennessee
Vimal V. Reddy, PharmD
VP, Payer Strategy, Market Access
Lockwood
Financial Relationship Disclosures:
| Faculty/Reviewer/Planner | Reported Relevant Financial Relationships |
| Joseph DiBiase Jr., CPhT Peer Reviewer | None |
| Fred Goldstein Faculty, Planner, Peer Reviewer | None |
| Tracy McDowd, PharmD, FAMCP Peer Reviewer | None |
| Brittany V. Henry, PharmD, MBA Planner, Peer Reviewer | None |
| Vimal Reddy, PharmD Peer Reviewer | None |
| Ruby Singh, PharmD Planner, Peer Reviewer | None |
- AMCP Staff have disclosed no relevant financial relationships.
- If applicable, relevant financial relationships have been mitigated and documented.
- Content has undergone a peer review to ensure content validity.
Available Credit
- 1.00 Certificate of Completion