340B The Carve-out of the Pharmacy Benefit from Medicaid Managed Care and Fiscal Implications
New York State is exploring various methods to balance the State’s budget deficit. One of the leading initiatives is to carve-out the pharmacy benefit from Medicaid managed care. This initiative could result in a trickle-down to the CHCs’ net margins they receive under the 340B Discount Drug program. Presenters will focus on how this carve-out could impact financial performance, provide a financial projection template as well as guidance on financial performance enhancement strategies.
- NYS Community Health Center Board Members and Executive Leadership
Peter Epp, CPA (CohnReznik)
Peter Epp is partner with CohnReznick and serves as Leader of the Firm’s Community Health Centers Industry Practice. With over 30 years of experience, he is a nationally recognized expert in ambulatory healthcare reimbursement and financing and is a frequent lecturer at seminars and workshops on Value Based Payment and payment reform, third-party reimbursement maximization, strategic business planning, cost report preparation, federal grantsmanship, financial operations assessments, and managed care.
Peter has been actively involved with health reform and the implementation of reimbursement systems for FQHCs across the country. He has been active with the implementation of Delivery System Reform Incentive Payment (DSRIP) programs and Value Based Payment (VBP) models in many states. His in-depth knowledge of the interaction between third-party reimbursement and grants management enables his clients to tap into ancillary services, including operational reviews, strategic planning, health reform readiness, cost containment and revenue enhancement studies, litigation support, and related technical assistance.
Marie Mongeon (CHCANYS)
Marie works with the CHCANYS Policy Team to monitor and report on proposed state and federal legislation and regulations, write public comments and other policy-related materials, and staff CHCANYS’ meetings, among other work.
Prior to joining CHCANYS, Marie worked in Washington, DC as a Research Associate with the Funders Forum on Accountable Health, a project in the George Washington University’s Department of Health Policy and Management, where she researched federal, state, and local community-based multi-sector innovations seeking to improve population health through addressing health and social needs. Marie has also worked on research related to federal and state regulation and legislation of health information, including health information technology and exchange.
Marie holds a Master of Public Health from the George Washington University Milken Institute School of Public Health, and a Bachelor of Arts from the University of Rochester. She recently relocated back to the Capital District and will be working out of CHCANYS’ Albany office.
Jason Reddish (FTLF)
Jason focuses his practice on the federal 340B drug discount program and the complex legal and compliance issues facing safety net providers, pharmacies, and other 340B program stakeholders. Jason began his career representing pharmaceutical manufacturers before finding his passion helping 340B program covered entities, including disproportionate share hospitals, Federally Qualified Health Centers, Ryan White HIV/AIDS clinics, and other grantees navigate the 340B program. [Full Bio]
Registration for the Board Leadership Institute is being conducted by the Community Health Care Association of New York State (CHCANYS).
To register for the Institute, click here.
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