Government Pricing

Ensuring compliance with ever-evolving, complex government regulations is an ongoing struggle.

Slight errors in calculations can result in large fines, overpayments, and a tarnished brand.
Rules and calculations are open to interpretation, which can create inconsistency in how legislation is translated into operations across divisions.
Gaps in data availability hinder teams’ ability to generate the reproducibility and audit trails necessary to demonstrate compliance.

Benefits of Model N Government Pricing

Align commercial, Medicaid, and government pricing

Connect payer and provider contracting and Medicaid claims processes with government pricing to gain visibility into the impact of commercial pricing strategies and make necessary adjustments.

Ensure timely government reporting

Accurately calculate every transaction, price, rebate, and adjustment that could impact monthly and quarterly reporting.

Reduce risk

Ensure regulatory and operational compliance with full reproducibility, an audit trail, reporting, and analysis.

Efficiently comply with complex government pricing requirements

Government compliance with Model N empowers you to achieve accuracy, reproducibility, and auditability so you’re always compliant and audit-ready.

Inflation Reduction Act compliance

Effortlessly calculate Medicare Part B and Part D inflation rebates per unit, seamlessly integrated with master data for potential inflation rebates processing.

Maximum Fair Price

Ingest MFP refunds for accurate price calculations in impacted government calculations.

Regulatory update packs (RUPs)

Stay up to date with current guidance through timely released software and documentation updates.

Formula builder

Leverage preconfigured calculations or modify formulas based on your interpretation of regulations.

Government price reporting management

Meet monthly and quarterly requirements for average manufacturer price, best price, average sales price, federal ceiling price, non-federal average manufacturer price, and U.S. Public Health Service.

Add-ons

Make your government pricing solution even more powerful.

Discount Reallocation Management

Comply with the mandates for bundled drug sales outlined in the Deficit Reduction Act by confidently executing complex contracting strategies and properly report resulting discounts.

Federal Supply Schedule compliance

Track commercial pricing to ensure any prices offered that are commercially better than the “Big Four” and/or other government agency (OGA) prices are reported to the VA in accordance with required timelines.

Alerts Management

Send configurable notifications to monitor key events and compliance issues.

Improve your entire revenue management process

Model N helps you execute efficiently today and gives you the power to scale tomorrow. Purpose-built for pharma, our intelligent cloud-based platform, advanced analytics, and value-added services manage the end-to-end commercialization process – across gross to net, compliance, global market access, and beyond.

See why Model N for pharma