Pharmacy Benefit Management Strategic Partner:

Our strategic partner offers a variety of services to assist PACE organizations with the management of Part D benefits. These include the following:

  • pharmacy network contracting;
  • prescription drug claims processing and adjudication;
  • rebate submission and payment;
  • TrOOP (True Out Of Pocket costs) reporting;
  • support in implementing the PACE organization Part D compliance and Fraud, Waste and Abuse Program;
  • assistance in complying with CMS Part D reporting requirements;
  • prescription drug event submission and reconciliation;
  • pharmacy help desk administration; and
  • management and utilization reporting.

Pharmastar

Pharmastar offers a range of services specially tailored to meet the needs of the PACE industry. With over 20 years of experience, Pharmastar is a PACE-focused Pharmacy Benefits Manager that provides organizations with Part D administrative, compliance, reporting, and clinical services and support. Let us worry about Part D so you can focus on your participants.

We offer the following services:

Administrative Services

  • Claims Processing and Payment
  • PDE Management
  • TrOOP Support, Including AutoTrOOP Processing
  • P2P Management
  • Part D Bid and Reconciliation Support
  • Government and State-Level Reporting
  • Encounter Data Support and Submission
  • DIR Rebate Administration
  • Executive Summary Reporting Suite
  • Executive Benchmark Reporting

Compliance Services

  • 1/3 Financial Audit Assistance
  • Pharmacy Audit and Oversight
  • B vs. D Reporting
  • ESRD Benefit Support
  • Enrollment Monitoring Assistance
  • CMS Memo Support
  • Acumen Support

Clinical Services

  • PACE-Specific P&T Discussion Forum
  • DUR Programs
  • MTM Program Development Support
  • Access to Clinical Pharmacists with Part D Expertise
  • Clinical Pharmacist-Led Utilization Review
  • Clinical Reporting
    • Polypharmacy
    • Beer’s List
    • Psychotropic
    • Anticholinergic
    • Opioid
    • Targeted Medication Class
    • Clinical Benchmarking

Contact

There are more than 260 PACE centers in 31 states. Find your local PACE program.

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