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Mark Kinney: Let’s see, do we have still have some participants joining?

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Mark Kinney: Yeah, we’ll just give it just 1 min. It looks like they’re letting folks in.

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Mark Kinney: Okay? Well, I think we’ll go ahead and and get started. My name is Mark Kenney. I’m the executive Vice President of Government Relations for the Independent pharmacy cooperative.

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Mark Kinney: And so today, Ipc is pleased to partner with Cms on providing an educational webinar

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Mark Kinney: regarding the upcoming Medicare prescription drug

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Mark Kinney: negotiation program that is will begin on January 1st of 2026,

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Mark Kinney: and with that I’ll turn it over to Michael Mccormick with Cms. To introduce his panel participants and start the presentation. Michael.

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Michael McCormick: Yeah, thanks, Mark, and good afternoon. Everyone. Thanks for having us really appreciate the opportunity to tell you a little bit more about the Medicare Drug Price negotiation program, but in particular the Medicare transaction facilitator. So my name is Mike Mccormick. I’m the director of the division

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Michael McCormick: of manufacturer data and inflation, rebate operations within the Medicare drug, rebate negotiations, group and join with me. Today is Brendan, Folsom and Brendan. You can introduce yourself.

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Brennan Folsom: Yeah, thanks, Mike. As I said, I’m Brandon Folsom. I’m the director of our division of manufacturer compliance and oversight. And yeah, as I said, appreciate you all taking the time to join today to talk a little bit about the program and

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Brennan Folsom: the Mtf. Specifically, I’ll go ahead and get us underway. On the content. We’re gonna walk through a deck this afternoon. Expected to take 20 or 30 min, and we want to make sure we carve out plenty of time for questions on the Mtf. And on the program in general. So

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Brennan Folsom: once we get through the content, feel free to jump in with questions. If you want to raise your hand, come up. You ask that way. You can throw them in the QA. Box. We can monitor them that way as well. But hope to to carve out plenty of time this afternoon for some good discussion.

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Brennan Folsom: With that. Let me start with just a quick disclaimer. That this is standard of what Cms does in our usual webinars on this area. Just noted the information provided in the presentation is only intended as a general informal summary of the technical legal standards and operational processes. It’s not intended to take the place of any statutes, regulations, formal policy, guidance that it’s based upon. We’re summarizing current policy and operations as of today.

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Brennan Folsom: Links to the source documents will provide along the way. These are for your reference. We definitely encourage you all to refer to the applicable statutes, our final guidance, and other materials that we put out for the complete and current information and the requirements that apply to them.

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Brennan Folsom: Without. Let’s take a look at what we’ll do quickly this afternoon. We want to start with just a general, some general background information. The, we’ll talk about the price negotiation program broadly. Just so there’s some context there. And the Medicare transaction facilitator specifically give some overview and background of of what it does and what it’s for.

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Brennan Folsom: We wanted to spend a lot of time today talking about the Mtf enrollment process we’re now open to enroll in the Mtf. This is going to be a big push the back half of the year. Make sure that that pharmacies are getting

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Brennan Folsom: in and onboarded to the system, and are ready to go for January, as Mark mentioned.

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Brennan Folsom: So we’ll we’ll talk a lot about the the process. We’ll talk about some operational considerations, and some need to knows for the enrollment process. And then wanna make sure we leave you all with some links to some resources as well, that go into a lot of detail and provide a bunch of background as well. And, as I said, we’ll save questions. We’ll save time at the end for for questions and discussion.

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Brennan Folsom: so to kick us off. I’m sure many of you are pretty familiar with the negotiation programs existence in general. But just to provide a little bit of level setting background here. Negotiation program was part of the Inflation Reduction Act Cms has been working for the last couple of years on implementing this new program that allows Medicare to negotiate directly with drug manufacturers the prices of drugs that are covered under medicare part d.

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Brennan Folsom: right now, we’re just focused on part D, part B will be rolling out in the future but generally those through those negotiations we reach agreements with drug manufacturers on prices that the

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Brennan Folsom: part D plans will reimburse, and that beneficiaries will have access to under the program, and to that. The requirement here is that those agreed upon prices which we call maximum fair prices, the part d plans will reimburse no more than that maximum fair price.

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Brennan Folsom: Now, what we realize operationally is that many pharmacies will continue to pay more than that maximum fair price to acquire these these drugs. Once these maximum fare prices are in place which starts in January. So what we’ve done here is develop this

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Brennan Folsom: new platform. The Medicare transaction facilitator to provide the connection in the supply chain between the manufacturers and the pharmacies, both to exchange data from the to the manufacturers. So they’re aware of which of their drugs are being dispensed at that maximum fair price. The quantity of those expenses, various things that are already existing in the Medicare claims flow and connecting the manufacturers to pharmacies

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Brennan Folsom: to process these Mfp refund payments. So these are payments that will accompany the reimbursement that comes from the part d plans

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Brennan Folsom: to set in that gap of what the difference between what acquiring the drug and the Mfp. Is

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Brennan Folsom: and important to note. There’s. So there’s there’s enrollment requirements which we’re going to go through today and we’ll talk through the straightforward process to get signed up.

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Brennan Folsom: It is enrolling in the Mtf. Is not committing any pharmacy to anything broader under the part d program. Y’all, I’m sure, are beginning to work with your plans on the contracts with part D plans for next year. The Mtf. Sits sits apart and aside from that, but it is important to

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Brennan Folsom: get enrolled in the Mtf. Is the tool will be there waiting for you. If you enter a part d agreement when you, or if or when you dispense any part, D drugs that have these maximum fare prices. But that, said the the process that you go through to enroll it’s not committing you to anything broader with with medicare part d at this time.

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Brennan Folsom: So what is this? This? Mcf. How does it? How does it work? What does it do? So, as I mentioned. This is a it sits between in the supply chain, between manufacturers and the pharmacies, to offer this critical information and and funding exchange as needed. The the key here really is providing a tool, and Cms has been committed to doing this since the inception of the program. We’ve worked very closely with

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Brennan Folsom: stakeholders on on both sides here to make to make this work and make sure it’s working for everybody. But we really want to provide the tools that make this program implementable.

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Brennan Folsom: And a big part of that is getting data to the manufacturers in a timely fashion and processing these Mfp refund payments back to pharmacies also in a timely fashion. That’s at the core what the Mtf. Is designed to do.

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Brennan Folsom: The Mtf. Is also going to have a host of other services available to pharmacies. Things like accessing the manufacturer’s Mfp. Effectuation plans which are going to describe some details about the processes operationally that manufacturers have to make Mfp. Available, as they’re obligated to under the statute.

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Brennan Folsom: And there’ll be some things like reporting functionality that allows, you know, pharmacies to track claims over their life cycle where they are in the system when refunds are being processed, when to expect them. Things like that. There’s also some other general platform

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Brennan Folsom: features like you, managing users for your organization, adding, removing users. Things like that. That kind of makes for a seamless user experience. Here

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Brennan Folsom: you’ll you’ll see the Mtf.

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Brennan Folsom: Primarily on the pharmacy side as a single system, although it does consist of these 2 distinct modules. There’s the Mtf. Data module, and there’s the Mtf. Payment module again, in your interaction with the system. As you get enrolled and onboarded, you’ll experience it as a single platform. This, primarily is the Mtf data module side. This is what is facilitating the exchange of data to help effectuate those maximum fare prices so as you fill

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Brennan Folsom: prescriptions and submit your claims to the part D plans as you do currently, under under normal business practices, the Mtf. Will draw on that claims data from the back end. You know no additional steps that need to be taken on claims processing on the front end. The Mtf. Will feed certain claims data back to the manufacturers that cover the selected drugs.

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Brennan Folsom: and give them information they need to put together their

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Brennan Folsom: Mfp refunds. The the DM interface really is that single point of use. It all happens in the same place and other than enrolling and providing initial information. There’s nothing that pharmacies need to do to make that happen other than just operating business as usual.

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Brennan Folsom: Behind the scenes. Then there’s the Mtf. Payment module. This offers drug manufacturers an optional way to pass refunds from themselves back to the dispensers. And that, again, is that gap of what the plans will reimburse under the negotiation program, and what the acquisition costs of the drugs may continue to be.

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Brennan Folsom: So again, I think we’ll talk broadly here today, as the Mtf. Is one broad system.

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Brennan Folsom: But you’ll know that behind the scenes there’s a couple of different things going on here.

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Brennan Folsom: really kind of bottom line of our session this afternoon, as we get into more details. Enrolling to the Mtf. As a pharmacy is very important. This is going to be a key tool for pharmacies. Once these negotiated prices are in effect. This starts again. January 1, st 2026, and as you enroll the information you provide is going to be the conduit that enables your pharmacy to receive any of these applicable Mfp refund payments from drug manufacturers.

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Brennan Folsom: Again, it’s designed to support pharmacies in their operations in their normal course of business other than the enrollment information. There’s nothing you’ll need to do once you’re onboarded, we just, you know, we need that initial information, and to keep that information up to date over time to the extent applicable.

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Brennan Folsom: and it will also provide key information to your business. Such as a 35 s. Reporting on the claim level payment data like I was talking about earlier. That will really be an operational support. As you move forward with these negotiated prices in place.

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Brennan Folsom: importantly enrolling in it, using it. It’s completely free for pharmacies. And again, as I said earlier, it’s not placing any requirement on pharmacies to dispense these drugs, to engage with the part D program, to engage with specific part D plans. This is purely here to be there, if and when you need it. At any point you dispense a part. D drug that has a maximum fair price. After January the system will kick into gear as long as you’ve enrolled and gotten your information.

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Brennan Folsom: Set up.

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Brennan Folsom: So really, from that perspective enrollment, here is an all upside proposition. There’s no, there’s no requirements. It’s placing on you but and if you never dispense one of these drugs, or you don’t happen to dispense one of these drugs after 24. This it will sit there and be ready for when you do. But if there

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Brennan Folsom: enrollment is not processed and you do dispense these selected drugs, you’ll you’ll expect to have delays in receiving any of these refund payments. So again important to enroll, and we’ll talk about process wise

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Brennan Folsom: but important to enroll, we encourage you to enroll early, like I said. Enrollment is now open, and

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Brennan Folsom: it.

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Brennan Folsom: It’s an important step to take in the coming months to make sure that your pharmacy is ready to continue continue serving the part d program as we move into January.

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Brennan Folsom: With that, let me pass it back over to Mike, and we’ll talk some enrollment details.

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Michael McCormick: Thanks, Brendan. So yeah, everything Brendan said is is kind of the key. But we’re gonna talk a little bit about like how it works and and some of the things surrounding the this Mtf enrollment process. So

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Michael McCormick: the website is now live. If if anyone attended the launch event. I think it was

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Michael McCormick: June 5.th you know. Now you’ll know that it’s live. It launched on June 9, th 2025. So it’s currently open and ready to go. We have been sending invitations to points of contact listed in the Ncpdp. This National Council of Prescription drug programs, database for dispensing entities and associated 3rd party support entities with a link.

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Michael McCormick: the link to the website to enroll so hopefully.

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Michael McCormick: many of you have gotten that invitation. So far if you are listed as the Ncpd. Point of contact. But we can talk more about that in a little bit. We’re we’re kind of at the tail end of sending out our initial invitations. I think last

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Michael McCormick: tomorrow is is kind of our last day that we targeted to send invitations. But obviously, we’re gonna take another look to ensure that any of the bounce backs or any emails that didn’t make it through that we can. We can try to take a look and see if anything went wrong, or we can resend

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Michael McCormick: and again, so it’s this Ncpdp data queue pharmacy database. If you’re the organization contact in that database

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Michael McCormick: and have not received an invitation I won’t even say by July one anymore. I’ll say by the end of this week. Just please reach out to us at the email below. So Mfp. Medicare transaction facilitator@cms.hhs, Gov, that is the email address for the Mtf. And we’ll go to our help desk and we’ll get triaged appropriately through there, depending on the question.

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Michael McCormick: The next slide, please.

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Michael McCormick: So yeah. So when you come into the system, there are multiple roles. For an organization. So there’s this authorized signatory official. This is a a person that has appointed, you know, an appointed individual with authority to legally bind the organization. So this will be the entity that will be responsible for signing the Mtf. Agreement and the ability to represent the organization in an official capacity.

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Michael McCormick: and act on behalf of the organization. So there can be up to 3 authorized signatory officials in the system, and then kind of downstream from that. There’s an access manager. This is an individual that has the authority to

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Michael McCormick: to act on behalf of the organization, to

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Michael McCormick: do a couple of things in the system, view, modify, submit, certify completeness of accuracy of information, but also can invite other users to the system. So if you come in first, st if you’re the person in Ncpdp and you get an invite, and you come into the system and register. And then you say, Oh, wait! I’m not the authorized signatory official. The access manager would have the ability to invite the authorized signatory official

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Michael McCormick: or invite another access manager or invite a staff end user. So this. And if you have access manager privileges, you can invite other downstream users into the Mtf. And if you do invite them they’ll get a smart link to their email.

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Michael McCormick: They’ll have to go through that link which will bring them to your organization which is created in the system, and that link expires after 72 h. So just keep that in mind. We can talk about that a little more. And then there’s there can be up to 3 access managers and an organization. And then the the kind of

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Michael McCormick: lowest level role as a staff end user. So an individual authorized to view and kind of look at information within the Ntf. Submit complaints and disputes after 1, 1, 2026 and there can be up to 10 staff end users at an organization.

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Michael McCormick: So next slide, please so

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Michael McCormick: talked about it a little bit. But the steps to getting in so initial enrollment steps. So step one, the initial Ntf, DM, user for each entity will receive this link. Basically, mtf.cms.gov, you’ll be able to see that. But we’re we’re that. That’s the link we’re we’re using to get people into the system. So we’ve sent out emails for these entities, and then you will have to come in based on using that link you have to go through.

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Michael McCormick: Well, we’ll talk about chains first.st So for chains. The emails be directed to addresses associated with the contact name from the relationship demographic table. If you’re a chain and there’s some information there about where you can kind of find that information, but it’s the

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Michael McCormick: primary point of contact for these dispensing entities or this contact name from this table for chains. But when this entity receives that that link, they can go into the system and complete this remote identity proofing process. Right. So this is like establishing that you are who you say you are. Mark comes in. We want to make sure mark is Mark, and he established himself as mark. And then.

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Michael McCormick: you establish username, password and log into this Ntfdm user interface. In doing this, mark would then be verified against Ncpdp data queue contact information during the initial login. So not only do you have to verify that you are who you say you are, then the the database kind of pings mark to ensure that he’s in the Ncpd. Database, and that’s our validation for getting only the correct people into the system. As these 1st users to the system.

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Michael McCormick: So next slide, please.

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Michael McCormick: So then, this initial user will confirm kind of like what I said before, where they’re an authorized signatory official for the entity. If Mark comes in he gets ping through. He says, Okay, I’m the authorized signatory official. Great. Now I can. I can keep going and sign my agreement. If I’m not. If he’s not the authorized signatory official.

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Michael McCormick: he can invite an appropriate individual at his organization that he should be aware of to serve in this authorized signatory official role. And then these authorized signatory officials or access managers can then designate downstream user roles within the organization.

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Michael McCormick: So let’s say Mark isn’t the authorized signatory. He then defaults as an access manager. He invites someone else into the system. When that person comes in using their smart link. The authorized signatory official can process this Mtfdm user agreement

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Michael McCormick: and then

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Michael McCormick: either mark or another user can complete the required enrollment form data elements that are defined in the Ntf. Icr, which you can find on our web page.

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Michael McCormick: But these authorized signatory officials or access managers may populate the data into this form. This is all kind of in the user interface. This is kind of the information we’re collecting the Mtf.

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Michael McCormick: And then the authorized signatory official or access manager, once complete, must certify and submit the finalized populated enrollment form. To complete this enrollment. And then, following certification, the enrollment information will appear as read only with separate system functionality for make sure making future updates as needed. So we have that piece in this enrollment piece. And in the future. We’re going to be deploying additional functionality to be able to update and and change that data on an ongoing basis.

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Michael McCormick: So it sounds complicated. But just want to let you guys know, like we have already in the last, you know, 2 weeks have hundreds of users in representing thousands of pharmacies. So. And and you know we’ve gotten some questions to our help desk, but not a ton. So it’s it’s a little more straightforward than it sounds right here. And we also have videos, and information on our website to kind of help get you through, including a user guide.

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Michael McCormick: Okay, so there’s

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Michael McCormick: So so this is talking about multiple chain codes and 3rd party support entities. So one of the good things about our system is that there are. We’re linking to this Ncpd database. Right? So if you’re an entity that utilizes chain codes, if you’re a chain, those can kind of connect to your profile when you set this up, or if you’re working with 3rd party support entities, some of that information has the ability to be populated into the system.

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Michael McCormick: So if you’re linking users to multiple chain codes during this initial registration, the Ntf. Will find all entities matched to a 1st user’s name and present that list to the user. And then that 1st user will have to select each entity and perform an email challenge to link the entity to ensure proper security and linking correct users to correct pharmacies.

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Michael McCormick: So if all entities are not during not linked during initial sign on the user can come back and link later. So essentially, if you come in and you’re related to multiple organizations. If Mark has 2 pharmacies, he’ll have to come in. Ncpdp will ping that marks in the system he’ll get through, and then it’ll list both of Mark’s pharmacies in the system. He’ll have to select each entity, perform an email challenge to get an associated email from each of those work addresses and then kind of create that organization within the system.

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Michael McCormick: And then for enrollment, each chain code will need to enroll. So the Mtfdm user agreement, the enrollment form and Payment Center remit linking must be completed for each chain code. So

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Michael McCormick: each each chain has a chain code, and then there has to be. There’s this, there’s this piece where you have to select your banking information, and also your remit where you want your electronic remittance advice to go. And you have to do that for each individual chain code or each individual. You know, dispensing entity. If you kind of have single Mpis.

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Michael McCormick: and then the provider pay model and remit. So there’s 1 payment center and one remit has to be established for each distinct entity. This could be a chain or an individual entity, and as many chains. As many chains, user provider pay model and have themselves listed as a payment center. These entities will be found during the user linking function in the same manner. So

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Michael McCormick: if you you know, if you’re an organization that has a chain, but also uses your same organization as the payment center that will be available, based on how you have it set up in Ncpd.

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Michael McCormick: and again, some of this can can sound confusing here. But we do have instructional videos. That kind of show you how it looks in the system.

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Michael McCormick: Guys go to the next slide, please.

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Michael McCormick: Okay, so an Ntfdm enrollment, we get a lot of questions about dispensing entities. And these 3rd party support entities right and who has to enroll? So the answer is, both of them have to enroll. So the dispensing entity would have to come in, and then a 3rd party support entity, even if they’re working together, also has to roll enroll in the Mtf. Separately. So each of them have to enroll. They have to fill out their associated

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Michael McCormick: enrollment questionnaires. There’s a dispensing entity questionnaire included in this is where you self determine preferences for receiving refunds. Your electronic remittance advice and then method

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Michael McCormick: for you know whether you want paper, check or electronic funds transfer payments. And then on the 3rd party support entity side. There’s also an enrollment questionnaire

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Michael McCormick: and Tpse should not do anything on behalf. They’re they’re not filling out a questionnaire for independent pharmacy clients. Right tpses fill out their own information, dispensing entity fills out their own, and then a dispensing entity can select tpses. You know any Tpse and Ncpd database based on their own profile. And then that that’s how things get linked in the back end of the system.

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Michael McCormick: Okay, so

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Michael McCormick: Mtf pharmacy operational consideration. So this is what we’ve alluded to before. But all of the data we’re kind of using on the back end is validated through this Ncpdp data queue database. So during enrollment you can choose to authorize the Mtfdm to use the data from this database. So if authorized, the Mtfdm. Will match your enrollment to the Ncpdp data. So this is kind of helpful. If you

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Michael McCormick: have have your data updated, we can kind of pre populate certain pieces for you. So it’s not as complicated. When you come in, it’s a little little less burden, so this will enable you to import your information. Name addresses Npi. 10 into the enrollment form for your review and verification.

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Michael McCormick: Ncpdp data will also match the name of any applicable 3rd party support entity you indicate during enrollment. If you indicate during enrollment that you’re using a 3rd party support entity to process payments and or remittance on your behalf.

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Michael McCormick: And if you don’t authorize the Mtfdm. To pull this information. You’ll just have to manually enter or upload all necessary information to the Mtfdm. Directly during enrollment. But we’ve been recommending that people Update. Ncpdp. You know, over the past couple of months we’ve been kind of preaching it. So when you come into the Mtf. Everything’s as seamless and accurate as possible.

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Michael McCormick: so again, yeah, this this kind of reiterating that. But we encourage all dispensing entities, especially those who intend to use this kind of pre-population feature to update their information as soon as possible. We’re recommending doing this at least 2 weeks ahead of time. So we’re getting feeds as often as weekly from Ncpd and trying to keep this data up to date.

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Michael McCormick: But we want to say every 2 weeks just to be safe in case you miss kind of the cutoff period of the data. So if you have not updated Ncpd in a long time and have no idea who your point of contact for your pharmacy is that should probably be your 1st step. And then, if you are making an update in Ncpdp, if it looks wrong and you have to change something. I’d wait about 2 weeks before enrolling into the Mtf.

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Michael McCormick: If you check into Pdp today, and everything looks good and go ahead and and you know. Follow the instructions for enrollment if you’ve received that email from us.

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Michael McCormick: So all dispensing entities should ensure their authorized official in the Ncpd. Pharmacy. Database is up to date.

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Michael McCormick: Please note the changes will not immediately populate. This is what I’m saying. There’s there could be a little bit of a lag. So just just watch out for that. And then you can update your information at Ncpd access online. And if you have questions on that, you can email Ncpdp or email, our help desk, and we can try to assist you there.

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Michael McCormick: Keep going, so help desk support and resources. So, as I said before, we have a dedicated help desk for users of the Mtf available via phone and email. So we have our, you know, dedicated number on the screen here that Mark can share with you guys. And then

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Michael McCormick: there’s a 0 here. But it should just be Mfp. Medicare transaction facilitator at Cms. At ages of not sure where the 0 came from. But that’s our email address. If you have, you know any, any

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Michael McCormick: policy operational questions issues, regarding the Ntf just reach out there and then. This is just a note. Our hours of operation for this help. Desk

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Michael McCormick: 7 am. To 7 pm. Eastern Standard time. Monday through Friday, excluding Federal holidays. And this Thursday is A is a Federal holiday, just as a heads up

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Michael McCormick: the help desk can support with user access issues system users with navigating Mtf. Addressing inquiries related to reports, files, data, exchange, all that type of stuff. And then, obviously, anything that’s a little more higher level. We’ll get triage higher. And we can help with that.

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Michael McCormick: So

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Michael McCormick: as noted previously, we have a lot of resources, including videos, a user guide a lot of things to help with the Mtf. This page is a great resource. It’s it’s linked to Cmsgov. But you know, mark can give you this this website as well. But this pharmacy and dispensing entities resource page

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Michael McCormick: fact sheets. Faqs, we’re trying to update as new questions come in to keep those as up to date as possible. User guide for how to use the Mtf informational video kind of like smaller in instructional videos for users where it can be like, I’m having issues in Idm, or now I’m on my enrollment form, and it kind of splits them up into more digestible videos.

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Michael McCormick: an 8, 35 companion guide draft. So we’re also planning to put out an 8, 30

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Michael McCormick: 5 final companion guide later this summer, but basically helping dispensing entities. Be ready for this

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Michael McCormick: 8, 35, and remittance advice. We’re planning to provide to accompany payments that come out of the Mtf. And then we also have this Mtf. Listserv. If you haven’t signed up already, please sign up we’ll provide that link as well. But you know, if you get on that email list, it will send you

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Michael McCormick: information when new resources come out. Potential educational opportunities. And you know, other resources as they, they become available.

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Michael McCormick: So yeah, we we kind of

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Michael McCormick: cruise through it a little bit here, which is good. I know we have some questions

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Michael McCormick: that came up throughout the call. But anything else you want to add Brennan or Eric, before we

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Michael McCormick: jump into some of those.

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Brennan Folsom: No, I mean, I think we’ve hit. This is again a lot of information very quickly. Right? So

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Brennan Folsom: doubling down on our encouragement to go check out those resources, visit the web page. And let’s take advantage of the time we have today to get into some questions as well, but generally, you know, generally we are standing by to lend a hand whether through our help desk so reach out. If you’ve got questions as we move forward from today, but definitely access those resources. And we look forward to getting everybody on boarded.

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Michael McCormick: And I just want to ask one question. I know that’s not what I was supposed to do. But has anyone on this call attempted to sign up for the Mtf. Yet, or has signed up for the Mtf.

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Michael McCormick: If anyone notes that mark, just let us know cause I like to

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Michael McCormick: hear from them as well. But we’ve we’ve had some good enrollment so far, so just just kind of curious on that end.

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Michael McCormick: Alright. Well, we can. We can get to it at some point. But yeah, be curious to know if if anyone did

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Michael McCormick: So, Brennan, do you? Wanna how do you wanna handle this.

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Brennan Folsom: Yeah, we got one hand raised. Let’s start with that, and then we’ve got a handful of questions have come into the box as well. But Sam sheth. Do you want to come off and

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Brennan Folsom: kick us off with a question.

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Michael McCormick: Are you able to unmute yourself, Sam? There you go.

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Sam Sheth: Yeah, I did. I do. I’m sorry.

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Sam Sheth: Can you hear me?

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Brennan Folsom: We can.

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Sam Sheth: Okay, I’m sorry. The work, too. Sorry. Okay. I mean, I I kinda literally got an answer for the question, since it’s already done now. But I how long does it take to finish the whole process from A to Z kind of thing? If everything goes smoothly.

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Brennan Folsom: Yeah, it’s a good question. It varies a little bit depending on like complexity of your organization. You know, if you’ve got a lot of pharmacies. It takes a little bit longer, but we’re we’re clocking it anywhere between about 30 min and an hour to make sure it’s all sewn up.

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Brennan Folsom: No, no, and sometimes faster than that.

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Sam Sheth: But the whole process to finish from all steps from beginning to end. If everything goes smoothly.

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Michael McCormick: Are you talking about payment process.

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Sam Sheth: No, no, no.

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Michael McCormick: Oh!

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Sam Sheth: No, no, to, for the enrollment process, from all steps to finish it from beginning to end. Like, does it take 4 weeks, 6 weeks, 8 weeks from A to Z, until okay, I’m going to start process from today and then finish it out step by step by step by step.

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Sam Sheth: And how does it go through that? Every every step of the way we get email for the confirmation or or kind of do you know what I mean? Does it break down into stepwise? Or how is being done with the application wise for the enrollment process? Wise.

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Brennan Folsom: Yeah. So it’s it’s really the. This initial enrollment and onboarding is very

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Brennan Folsom: quick and straightforward, like, I said.

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Brennan Folsom: should be under an hour from when you kind of, you know, assuming you’ve kind of got your information ready to go and enter into the system. You know, an hour. An hour, ish, I would say, and we’ve seen folks do it faster as well. There will be.

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Brennan Folsom: So basically. For now you know, we’re doing this pre enrollment, making sure everyone is is up and running.

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Brennan Folsom: there will be some testing and things this fall with, you know, syncing up banking information, making sure that those are all squared away as we get into January. So that’ll kind of be another step before January. But really, for now the the process here

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Brennan Folsom: is

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Brennan Folsom: you know. About an hour, I would say, and Erin Mike feel free to jump in with any other contacts.

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Sam Sheth: Once I start the application within an hour I will get the answer back, saying that, okay, you are done. You’re enrolled now, that’s what it is.

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Brennan Folsom: That’s right. Yup, okay.

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Michael McCormick: Yeah, it should show in the system that you’re you’re certified. And there are, I think, like as you’re going through the enrollment form, there is the ability to like, save and come back to it. But.

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Sam Sheth: –

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Michael McCormick: It seems like most people are getting through it pretty.

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Sam Sheth: Okay.

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Sam Sheth: Okay. Yeah. Good.

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Sam Sheth: Good. Good. Okay. Thank you.

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Michael McCormick: Oh, okay. And then there’s 1 other androids.

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Michael McCormick: Yeah, that was in Bill.

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Mark Kinney: Michael. If it’s okay. I saw one of the questions that came through as is, the 3rd party support entities, the same as psaos, and the answer is correct. That’s how we understand the 3rd party support entities is through Psao, you know, offered the contracts with the with the Pdps.

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Michael McCormick: Yeah, I I think we left it kind of broader, because some people call themselves payment centers or remit centers, or whatever. So that we had this like generic term, for, like everybody but yeah, Psas would fall under that category for sure.

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Michael McCormick: So yeah, they they should complete the the psao enrollment, if they are

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Michael McCormick: kind of functioning as a payment or remit center for for any disciplinary entity.

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Joe Meinholz: Alright we can move on to Bill. If you wanna unmute, you can ask your question.

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Joe Meinholz: He’s on a phone so he may not

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Joe Meinholz: have the same natural ability to unmute.

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Joe Meinholz: Alright, let’s move on to the next hand raised then, and we’ll let maybe Bill try again.

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Joe Meinholz: and I would love to try and pronounce the name. I I’m gonna

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Joe Meinholz: butcher it if I try it. Aj Kumar, if you want to unmute.

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Ajaykumar Gajera: Now he’s okay.

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Joe Meinholz: Yes.

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Ajaykumar Gajera: Yeah, we hear you, do. We have to wait for the email from the Cms for starting the enrollment.

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Michael McCormick: So

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Michael McCormick: I think we would have said, yes. But since we’re, we’re kind of close to getting our initial invites out.

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Michael McCormick: If you

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Michael McCormick: have not received an email or don’t think you received an email. And you are. You believe you’re listed as the primary point of contact in the Ncpd data queue database, for you know one or more pharmacies or tpses. You can go ahead and try to enroll if you’re not listed right. If you’re just

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Michael McCormick: somebody. And let’s say your organization has somebody else listed as Nc. Bdp point of contact. If you go to the site after you complete your remote identity, proofing

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Michael McCormick: you won’t be able to get in. So you have, you have to be listed. It will verify against the Ncpd. Database. But if you’re if anyone is comfortable that they are listed as a point of contact for an organization in that database you can attempt to log in, and you can utilize

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Michael McCormick: mtf.cms.gov as the front door.

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Michael McCormick: So yeah. So the answer is, yes, you can. You can attempt to do it. You know, through that regular link for the the smart link that that only lasts 72 h. That’s if someone in your organization invites a downstream user. But for these 1st users that are listed in the Ncpd. Database. They can go to that Ntf. Website at any time.

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Mark Kinney: So, Michael? Another question that came through from candy. Mathis. What are the estimated lag? Times of payment to the pharmacy? Cash flow could be an issue.

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Michael McCormick: Yeah, I mean, this is, you know, this is the issue we’ve heard all along. And you know, it’s it’s just

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Michael McCormick: something that we’re doing our best to adjudicate but again, manufacturers on on the hook, they’re responsible for effectuating these Mfps making them available to beneficiaries. We’re trying our best to to jump in the middle and help make these connections. But

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Michael McCormick: in the in the C and D rule we’ve we’ve reduced the Pde. So so we’re using prescription drug event data to kind of start this process. Right? So you guys submit your normal claims to the plans

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Michael McCormick: they have to submit prescription drug event data to Cms, that’s kind of how it just works in general and part D,

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Michael McCormick: that timeline has always been 30 days. Right? We’ve reduced that submission timeline from 30 to 7 days for our Mfp. Or selected drugs right? So set they have up to 7 days to submit that data.

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Michael McCormick: We have to then get that data from this. You know. Pde,

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Michael McCormick: you know, from the contractor processes the Pde on the on the Cms side, we have to do kind of our processing to that data right? Ensuring that, you know it’s eligible. It makes sense. There’s no checks that kind of kick it out. We have to provide that data, then to the manufacturers. So we’re trying to get it to the manufacturers as fast as possible, because in our guidance they have a 14 day prompt payment window to effectuate the payments back to you guys. Right?

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Michael McCormick: So

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Michael McCormick: I mean, you know, good scenario. Let’s say, plan sends it after one day. Right? They’ve up to 7 days to submit their Pd, let’s say they send it day one right?

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Michael McCormick: Then, you know, Ddps, this drug data. Processing system gets

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Michael McCormick: the Pde, and then we get a feed from them. The next day, right day 2, we get through. We go through it, do a check. Pass that data to the manufacturer. Let’s say that’s luckily day 2, maybe day. 3 right? Best case scenario. Then the manufacturer kind of out of our hands has 14 days

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Michael McCormick: to return a file to us, approving to pay that amount if they opt into the Mtfpm. Right? So they opt into Mtfpm. They’re sending that back to us, and then we’re click. Quickly sending that information to the Ntfpm. Contractor. They have to pull the money from the manufacturer’s account, and then disseminate that money to you. Right? So

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Michael McCormick: it, you know, in a perfect world, it’s, you know.

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Michael McCormick: couple of days after the prompt payment window in like a you know, more realistic world. Probably you know

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Michael McCormick: 20 days, because if you have 20, some days depending on, like the Pde submission, because it takes a little time to send that data around and then turn those payments around. But from what we can control, we’re trying to do it as fast as possible. I don’t know Eric or Brandon, if you have

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Michael McCormick: thoughts on that but it’ll vary kind of a little bit based on Pde submission. Timeline cutoffs, you know, method of payment. Right? Obviously, if someone selects paper check that’s going to take longer than an electronic payment, all that good stuff. And then, again. If the manufacturer doesn’t opt into the Pm. The payment module, then they’re kind of on the hook for figuring out a way to to pay you guys within that time window.

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Brennan Folsom: Yeah, Mike, I think that.

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Brennan Folsom: it’s it’s a. It’s a great synopsis. I think there’s been some questions in the box about kind of.

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Brennan Folsom: you know. Why is it working this way? And I think just to clarify a little bit the the law, the statute, is very clear that it is the manufacturer’s obligation to make these Mfps available to dispensing entities and pharmacies.

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Brennan Folsom: So again, one of the things we’ve done here at Cms. To put this Mtf. In place. Is exactly because that that was an issue, right? The law says manufacturers need to do it. We’ve heard from the manufacturers. We’ve heard the pharmacies like. There’s no way for them to make that connection. That’s the goal and the purpose of the Mtf. And as Mike was saying, we’ve designed this with our really number one goal in mind of minimizing the lag time that that occurs by

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Brennan Folsom: so that you know, that’s where where we’ve landed to date and kind of why the the flow is working the way it’s flowing.

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Brennan Folsom: but again, the the goal of the Mtf. Is to move things as quickly as possible, I think to to Mike’s point.

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Brennan Folsom: We’re moving on data as soon as we receive it. So you know, the plans have 7 days to get us the data. But if it comes in on day one, we’re moving that data on day one. The manufacturers have 14 days. If it comes in on day 3. We’re moving the payments on day 3. So there’s no lag time. There’s no batching at the Mtf. Everything’s gonna flow in real time as much as we can. But there’s only so many things we can control. So. But we, we absolutely share the

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Brennan Folsom: objective here to make sure that these payments flow as as quickly as they possibly can. Given the circumstances that we have, I think, one other clarification

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Brennan Folsom: that is coming up in the the chat box here that that Mike alluded to is that the Mtf. Pm. That payment module I talked about earlier being optional to manufacturers. It’s it’s not not the case that the

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Brennan Folsom: effectuation of these maximum fare prices to pharmacies is optional. That is an obligation that the manufacturers have in the statute. It’s something that is enforceable by Cms and something that we will be conducting pretty stringent monitoring and oversight on, to make sure that these maximum fare prices are being made available.

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Brennan Folsom: however, the because the statute language again is, puts this in the purview of the manufacturers to make these available and puts them, gives them the obligation to do so.

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Brennan Folsom: There are a variety of paths that they could choose to do that with pharmacies, whether it’s they could, you know, sell drugs prospectively. They could enter into some sort of a couponing situation, or, you know, there’s all sorts of ways. They may approach it. The Mtfpm. Is designed to be the path of least resistance for the manufacturers. I think we expect pretty good uptake of that. For that reason they’ve been equally concerned about linking up with pharmacies across the country to make this work.

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Brennan Folsom: So again, the Mtfpm fills that gap. But the manufacturers may choose to take a different option. That’s where these Mfp. Effectuation plans come in which will be available to pharmacies in the Mtf. User interface as well. That should a pharmacy choose a different approach

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Brennan Folsom: to effectuate these maximum fare prices. It will be well documented and detailed in those plans, and those will be accessible to to pharmacies as well.

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Joe Meinholz: There’s there’s a couple of questions in the chat about deadlines to register. Is there a specific deadline.

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Brennan Folsom: It’s a great question. What we’re basically saying is, as soon as possible. There’s and you know, kind of what we’re saying earlier. There’s there’s really no reason to wait. This is, you know, if you get in and you don’t need it.

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Brennan Folsom: No no harm, no foul. It’ll be there for you when you do need it. I think you know, at the latest I would urge people to get in there by September, October to make sure we’ve got some time this fall to make sure that everything is aligned and ready to go for January. That said

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Brennan Folsom: enrollment will be open on an ongoing and running basis. So if folks need to come in in January, or maybe they

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Brennan Folsom: realize they’ve started to, you know, serve Medicare patients that they hadn’t served before and need to get in. The enrollment will be open and available. But really no, no reason not to jump on this early, get it taken care of, and then not have to think about it.

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Michael McCormick: Yeah, and we will probably annoy you if you don’t enroll.

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Brennan Folsom: That’s another good point.

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Michael McCormick: Yeah, yeah, you know, yeah.

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Brennan Folsom: You’ll you’ll start getting more and more email traffic from us.

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Eric Stuart: Right. And then, just to add to those things, too. You know, if there’s an issue with the information you have added into Ncpdp. And that gets updated that could take up to 2 weeks for the Mtf. To receive that. And then just traditional banking rules and things like that. Once. A bank account is you know, shared for processing payments. It can take up to 2 weeks to do a pre note test, or like a penny test, or something like that, to confirm

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Eric Stuart: that a bank account is set up correctly, so those things could delay. If you delay too long, and you know. The payments would then be delayed.

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Joe Meinholz: Out of curiosity. Is there any way, are you able to share the Powerpoint presentation with us, and would we be able to distribute that to our members?

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Joe Meinholz: Or is it proprietary.

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Michael McCormick: I think we’re we would be prepared to let you share this recording so they could kind of like pause on the slides. Right? We? We have been passing out the deck, but, like if if Mark shares the recording with us, we take a quick look and approve, you could probably redistribute that among your members, if that works.

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Joe Meinholz: Okay. Thank you. Cool.

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Eric Stuart: See some other questions in there, one that says our pharmacy has 2 Ncpdp. Numbers, one for regular retail and one for long-term care.

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Eric Stuart: and we have been able to link our account for our long term care and not the retail. Ncpd, well, we get another email for that number. Both numbers are under the same email in their profiles. That’s a really good question. I know a lot of businesses are are set up like that that have a retail pharmacy and a long term care with 2 Ncpd. Numbers. As Mike mentioned, you could go to mtf.cms.gov and register

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Eric Stuart: so you don’t need a special link for each pharmacy, and what the Mtf. Will do will take that legal name that goes to the remote identity proofing and match that up with the names that are in Ncpd. When we find multiple matches of that name they will be both presented or multiple ones would be presented to the user. Where then they could click on a link to get the smart link to associate with that pharmacy.

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Eric Stuart: So if the legal name that the person coming on into the Mtf. Is the same as what’s in both the long term and retail business, it should automatically be found, and you should be able to find that

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Eric Stuart: if you’ve already done one, you can go into my account in the Mtf. And you could see, manage my organizations, and the other. One might be listed there, and you could complete the enrollment for that one. We do see instances where there are independents that have retail pharmacies and long-term care set up just like that, and they have different names in Ncpdp. To manage different businesses. So if they’re both not showing up, it might not be a name match.

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Eric Stuart: We are not using the email to do the matches. We’re using the email to verify a person’s association with the pharmacy. But we’re not using the email to link a person to the pharmacy for enrollment. So hope that answers that question.

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Michael McCormick: Think that makes sense. There’s a bunch in here.

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Michael McCormick: I’m trying to pick ones that kind of could help multiple people ones in here we have a psao, but also use

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Michael McCormick: some other entity for reconciliation. Will we sign up both again? If you’re a dispensing entity, you’ll sign up yourself and then link to

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Michael McCormick: a payment payment center, and then also like a remit center. So if you use one for payment and one for you know your reckons, your you know your your like accounting right where you you want to send payment to one, but want to send your era or electronic remittance advice to another. You have the opportunity to do so. And again you’re they would have to sign up separately, but you’re able to select them. And match them to your entity.

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Michael McCormick: I don’t know Brendan Erica any other specific ones you’re seeing that could help kind of a.

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Brennan Folsom: Yeah, I see one in here asking about the cash flow question in the enrollment process. So this, this is referring to a question on the enrollment form that asks whether you expect to experience material cash flow concerns. Given the transition away from full reimbursement, from the plan into reimbursement that is shared between the plan and the mfe refund by the manufacturer. This is an optional item. You can. So there’s 3 choices. Yes, no, or prefer not to answer

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Brennan Folsom: this information will be shared with the manufacturers to provide them some input to their main, their Mfp. Effectuation plans. I was speaking about earlier. One of the requirements

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Brennan Folsom: we have for the manufacturers in those plans is an approach to help mitigate any of these material cash flow concerns. So we’re collecting this information for the manufacturers. So they get a sense of the scope of pharmacies that are expressing these concerns to the extent that it helps them

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Brennan Folsom: craft a plan or an approach on their end to think about

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Brennan Folsom: how those will be mitigated. We spoke with manufacturers about this as well. You know, there’s obviously shared interest between the manufacturers and pharmacies to make sure that these drugs continue to be available in the marketplace. Manufacturers need the pharmacies to get these drugs out the door.

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Brennan Folsom: And so, while we aren’t putting specific requirements around what these mitigation plans are. Again, this is in the purview of manufacturers for effectuating the Mfp. We have heard from manufacturers this commitment and this is something they asked for some helpful information through the Mtf. To to help put some scope around it.

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Brennan Folsom: Great.

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Eric Stuart: Thanks, Brendan. I see a couple of questions here for pharmacies that have partnered with the psao. Will pharmacies be able to view access

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Eric Stuart: the refund payment data in the Mtf. In addition to the Psas. Believe this is going to work very similar to other systems and other relationships with psaos or remit vendors or things along those lines, so the psao will have access to remit information and things like that. The dispensing entity would not have direct access to the remit

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Eric Stuart: information, especially with a psao that’s doing a central pay. That remit is going to have claims in it for your pharmacy and other pharmacies as well. So we can’t expose that data to the pharmacy. That being said, there will be some level of reporting available, you know. There’ll be more to come on that, so there’ll be some visibility. But you won’t be able to see the remits.

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Michael McCormick: I see a question.

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Michael McCormick: I’ve attempted to enroll by getting through identity verification. Setting up my username and password, I ran into problems. When I got to a screen that asked what type of enrollment I was attempting to complete. I did not see Mfp. Or Mtf. In the long list, so I wasn’t sure what to select.

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Eric Stuart: I could address that one Mike. So what happened was there? And that issue should have been resolved. You you probably clicked on the link to get a verification code. It went to like a white screen, and then you

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Eric Stuart: on a different tab. You probably went to try to find the ridp, and ended up on a menu that got routed there, not through the Mtf.

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Eric Stuart: So if that was the case, that should have been resolved. And when you go back to log into the Mtf. There’ll be a button there to get a verification code.

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Eric Stuart: That’ll send you an email to a verification code. And then that Link will read. Once you enter that verification code, that link will route you directly to the place you need to go. So typically when you find that with the menu you ended up getting there. Not through the link in the Mtf. But through an outside source.

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Michael McCormick: And then I see a question you mentioned importance of enrolling. However, you also said if you didn’t, reimbursement would be more delayed. Can you clarify. So we’re basically just saying, Here, want everyone to enroll as soon as possible. But if for some reason you didn’t enroll by before 1, 1, 2026 and and enroll actually, probably earlier than that in time. To have your bank account, you know, verified, penny tested. Make sure everything was good to go

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Michael McCormick: in theory, right? There could have been claims happening in January that are going through that are being held up right. So if you’re not in the system, and you submit a claim on January second, right? We we won’t know who to pay it to right, so if you enroll late, it could delay your payment, you’d be entitled to that refund still. But if we don’t have anywhere to send the money, it’s gonna have to sit. So I think that’s that’s kind of what was meant by that. So just be sure you’re enrolled early. Just to make sure all your stuff is set up. So

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Michael McCormick: you know, when this data starts flowing, you’ll be you’ll be ready to go.

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Brennan Folsom: And I know we’re running low on time. Let me take. We can maybe squeeze in a couple more here. There’s 1 who do we contact if there’s a discrepancy. So I know we didn’t get a chance to talk about this yet today. So this may be good information. Inside the Mtf. There is going to be a complaint and dispute functionality for pharmacies, so there’ll be a form available

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Brennan Folsom: for any concerns that you may have about Mfp. Not being made available to your pharmacy. If it’s a payment that didn’t come through on time or at all, or it’s less than you expected, or less than you needed it to be, or if there’s some sort of a technical glitch in the system, some calculation, error, etc. You know anything that is in this discrepancy. Space. There’ll be a functionality within the system. You can submit that our way and we’ll receive those and investigate them as as they arrive.

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Brennan Folsom: So again, this is an important part of our oversight efforts for this program, and, as I mentioned earlier, we

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Brennan Folsom: are standing up a fairly robust process for monitoring Mfp availability. These complaints and disputes are going to be a direct feed into that so definitely another benefit of of enrolling and using the system is having direct access to a helpline for for things like that, too.

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Michael McCormick: Let’s see what.

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Brennan Folsom: Have.

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Michael McCormick: Oh, yeah, Brendan, I don’t know.

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Brennan Folsom: No go ahead! Back!

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Michael McCormick: Like question about support entities like P, big psaos, are they receiving emails as well as from Cms to enroll as a support entity. Yes, they are. And then also ask, Do they need to go through the process per pharmacy or aggregate? So they would go aggregate. Right? They’re signing up. They’re saying, Hey, we’re we’re signing up in the system as this 3rd party support entity that handles payment and or remit. And then, as

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Michael McCormick: the des dispensing entities enroll and come in.

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Michael McCormick: They would nominate this entity right? So they’re kind of getting connected one by one to all these dispensing entities that they support on the outside. But Health Mart Atlas wouldn’t have to come in and assign individual pharmacies that they’re working with. It kind of happens on the the De side.

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Eric Stuart: Cool. I see another question here similar. We have a Pso, but also use another vendor for reconciliation where we sign up both. The answer is, yes. When you’re doing your enrollment, you will select where you want payment to go to, and then separately select where you want your remit to go to.

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Brennan Folsom: There are a lot of questions left. These have been great questions and great discussion. So appreciate everyone’s engagement and just taking the time to to give this attention today is super important. I know we won’t be able to get to everybody. So I just want to quickly flag a couple of avenues coming up to continue to get your questions answered one. Of course, the resource web page we mentioned earlier. There’s an FAQ document on that

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Brennan Folsom: page. It does address a lot of the things that I’m seeing in here. So check out the Faqs, the videos, other things. That are on this web page, a super helpful place to be.

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Brennan Folsom: I’ll also flag. We’re gonna continue holding monthly pharmacy calls. The next one is actually next week. We can distribute some registration information about that. If folks don’t have it. And we’ll actually be holding very similar to this a general office hours style. Call for the coming months of folks can jump on, ask questions, make sure that you’re getting information you need.

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Brennan Folsom: So that’s certainly another another avenue of resource that’s coming up to to have on your radar as well. And then again, the help deck. If you’ve got questions either ahead of enrollment or during enrollment. You can send them all to that email address. We’re monitoring those on a daily basis as they come in and we’ll get back to you there.

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Brennan Folsom: And we’re we’re turning those out as quickly as we can, too. So if we haven’t gotten your question today, and it wasn’t covered by any of our other information or answers, feel free to send it to us via email. And we’ll definitely address it in that if we don’t see in one of our future events as well.

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Joe Meinholz: Likewise. You know, once we have approval to share the recorded webinar out we will post it out on our Ipc cooperative connection. We’ll also post it with links to the resources that you shared. I noticed they were shared in the chat as well, so by all means feel free to click on those and and visit we will also share those out with with all the Ipc members as well. Just so they have access to that information.

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Mark Kinney: Great. Well, I’d like to thank Michael Brennan, Brennan, and Eric for a fantastic, very informative presentation, and at this time we’ll conclude the Cms. Mtf. Educational Webinar. Thanks for everyone’s participation.

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Michael McCormick: Thank you. Guys.

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Brennan Folsom: Thank you, everybody. Take care!

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Michael McCormick: See ya.