ZYNCHROS EMBRACES CMS CHANGES FOR 2008 MEDICARE PART D RULES
Zynchros.com Platform Upgrades Eliminate Submission Crisis for Health Plan Sponsors and PBMs
Seattle, WA - 23 March, 2007 – In response to numerous announcements made by the Centers for Medicare and Medicaid Services (CMS) on March 20, 2007, Zynchros, Inc. today announced an aggressive schedule for the availability of enhancements to the Zynchros.com solution for Medicare Part D regulatory compliance. As the leader in Medicare Part D regulatory submissions and Pharmacy Program Management, Zynchros delivers solutions to their clients that simplify the regulatory process, reduce costs and improve the strategic impact of Medicare Part D formularies. The CMS changes were made via webcast just 6 days prior to the opening of the regulatory submission window for health plan sponsors for 2008 Medicare Part D.
“Many of our clients, especially those that are new to Medicare Part D, had no idea of the severity and impact of the announcements made by CMS”, said David Smith, vice president, Product Management at Seattle-based Zynchros. “The workload for plans transitioning from 2007 benefit year sponsorship to 2008 is tremendous. For those new to Part D in 2008, I suspect the challenges are proving somewhat overwhelming.”
Substantive Changes and Short Lead Times Create Health Plan & PBM Angst
More than 2,000 changes were made to the Formulary Reference File, which most plans had assumed would not change from year-to-year. In addition, the actual submission file format and rules have changed and CMS is requiring several new levels of coding that plans were not prepared for, including:
- Requirement to classify each drug by type (e.g. Generic, Non-Preferred Brand, etc.)
- Codification of every drug available only from Specialty Pharmacies
- Additional coding to reflect the Group Identifier for any drug requiring Prior Authorization
- Every drug must include the therapeutic classification and category name even if the formulary is based on the USP model formulary guidelines.
Several additional changes were made to the formulary submission process for 2008 plan sponsors.
Zynchros.com Eliminates Drudge Work, Smooths Compliance
Zynchros announced the 2008 Reference Formulary File, complete with coding for the 2008 USP Model Formulary Guidelines, is immediately available to Zynchros.com subscribers. This update also includes a “crosswalk” enabling automatic translation of 2007 formularies to the 2008 drug list. Changes to the Zynchros.com user interface to support the new fields and coding requirements will be made available on Friday, March 30. 2007. The final approved HPMS file format – generated automatically within Zynchros.com – will be available on Friday, April 6, 2007, enabling plans to automatically submit their files comfortably before the CMS-established deadline of April 17, 2007.
“I just read through the '08 HPMS changes and was surprised by the scope of their impact, especially at such short notice”, said Steve R. Nolan, Pharmacy Director, Rocky Mountain Health Plans. “It is a source of comfort to us that Zynchros is so proactive on our behalf in reducing the impact of this kind of directional change. The formulary upload process to CMS was a nightmare the last two years. So far our upload files, using Zynchros, have gone very smoothly. I am anticipating that our 2008 Formulary Submission will be similarly smooth and I am confident we can rest assured of a successful submission for 2008. I'm thrilled by the ease with which we can now manipulate the CMS formularies.”
“Although the Zynchros.com platform is an end-to-end formulary and Pharmacy Program Management solution for all plan benefit designs, we are absolutely committed to providing a comprehensive first class Part D solution”, said Marc Lilly, CEO of Zynchros. “From formulary creation, editing, analyzing, translating, CMS submissions and marketing requirements, Zynchros.com is an all inclusive solution that requires a fraction of the resources used by plans and PBMs that use spreadsheets or home grown programs. All across the enterprise (pharmacy, marketing, product management, IT etc), our clients tell us that we save them hundreds of thousands of dollars and compress the time cycle around Part D requirements.”
Specifics of the CMS announcements can be found on their web-site at http://cms.distributedclassroom.org/courses/6/
PRICING AND AVAILABILITY
The Zynchros.com Medicare Part D solution is available immediately. Pricing is based on an annual subscription. Please contact us at 1-866-996-2476
ABOUT ZYNCHROS, INC.
Founded in 2000, privately-held Zynchros, Inc. (formerly Script IQ, Inc.) delivers
technology-based solutions that transform the economics of drug-based wellness,
improving compliance and agility of health insurers and pharmacy benefit managers. The
Zynchros.com on-demand platform provides the workflow processes necessary to initiate
pharmacy quality management, improving responsiveness, control and efficiency by
synchronizing all of the participants in pharmacy benefits, from P&T to the point of care.
To learn more about how Zynchros is interconnecting the world of pharmacy benefits
visit www.zynchros.com or call 1-866-996-2476.
For more information contact:
ZYNCHROS, INC.
Terry Christiani
206.792.4106
terry.christiani@zynchros.com

