Contracts & Pricing 2022 Trends in State Pricing Transparency Reporting December 15, 2022 John WhitridgeDirector, Operational Consulting 3 Minute Read Editor’s Note: This is a two-part blog series covering the ever-changing requirements by states on Pricing Transparency Reporting. This blog will cover recent trends we’ve identified in 2022. Next in the series, we’ll examine best practices in compliance. When it comes to complying with state pricing transparency, manufacturers face many challenges. Currently 22 states have pricing transparency obligations and 35 have either first time or a second round of policy regulations that are being proposed. The scope of what manufacturers must be aware of and report on has never been larger and more complicated and certainly doesn’t show any signs of slowing down. Manufacturers need to have a baseline understanding and be aware of what states have regulations, what they should be considering when talking through certain scenarios, and considerations for certain actions whether it’s price increases, drug launches, or anything in that spectrum. It’s a lot of moving parts to be aware of to take action proactively and be compliant with these states. In 2022, states focused on refining their existing regulations rather than passing new bills. We’ve seen a lot of states such as Washington release version three or four of their material, templates, user guides, and definitions – even some reporting schedules have changed drastically from when the bills were originally enacted. Florida has a proposed bill that includes a potential price increase notice of 120 days as opposed to just the standard 60 days. These are the types of areas in which manufacturers need to make sure they are tracking, analyzing, and talking across internal teams because if new regulations go into effect, they need to have a good transition plan to account for new timelines. In evaluating the impact of reporting obligations, obviously a price increase strategy is part of the equation; however, when you need to plan that far in advance, there are certainly several other areas that pricing might impact beyond price transparency. Manufacturers need to make sure that when they are formulating and strategizing on price transparency that it also relates and flows well into any other areas such as government pricing, gross-to-net, and market access. Pricing teams need to make sure they are not operating in a silo and give internal teams plenty of time to understand the impacts broadly across areas outside of just SPTR. In 2022, we’ve identified four key trends as states refine their processes: dedicated portals, registration fees, maintenance requirements, and continuous updates. Dedicated Portals. A lot of states such as Texas, California, and Oregon use dedicated web portals to collect and ask questions from manufacturers automatically and more states will follow this trend. In the eyes of the states, it makes it a little bit clearer to manufacturers by having one hub where everything is submitted and collected, even reference reports from the past. Registration Fees. Registration fees are being added to an increasing number of states. We expect that trend to continue. Maintenance request. We see more states follow the expectation of paying a $400 or $500 fee once a year to maintain an active registration. Virginia and New Hampshire along with several other states have passed maintenance registration requirements. Manufacturers are required to submit an annual attestation stating something along the lines of “I’m still here. I’ve got a registration but there’s nothing to submit. I’m attesting I’ve done my due diligence and there’s nothing for us to complete. That’s why we didn’t submit X, Y, and Z reports over the course of the year or during the first part of the year.” Continuous updates. The last trend to touch on is continuous updates in which states are refining the requirements manufacturers must disclose and consistently reaching out to manufacturers requesting additional information. The good news is we’ve seen these requests for information, follow-ups, and questions come with an elongated reporting period, meaning states will give another 30 or 60 days to respond. 2023 is sure to bring more State Pricing Transparency trends and regulations. Ensuring your team is on top of the latest developments is imperative to your overall pricing strategy. At IntegriChain, we can assist in determining the right SPTR strategy for your portfolio. To learn more: consulting@integrichain.com Learn more about how you can proactively manage state price transparency in your organization: Blog: The Nuance and Necessity of Timely State Price Transparency Reporting Data Sheet: State Price Transparency Reporting About the Author John Whitridge Director, Operational Consulting John Whitridge has spent many years working with manufacturers in a consulting role before shifting his attention to growing his expertise in State Price Transparency Reporting at IntegriChain. His background includes successful project execution in many areas such as system implementation, managed care contracting, chargeback validation, and government pricing. He is currently overseeing a dedicated team of SPTR resources. John looks to expand the offering and opportunities to support manufacturers in the complex waters of compliance.
Contracts & Pricing November 4, 2024 Why I Chose IntegriChain: A Journey from Tech Giants to Transforming... 2 Minute Read
Contracts & Pricing October 31, 2024 Industry Shifts: A Closer Look at Recent CMS and J&J Announcements 3 Minute Read