The Pharmacists
The involvement of pharmacists began when the MSSC contacted Prescription Network of Kansas (PNK), a pharmacy benefits management company. PBMs manage the prescription portion of a health plan either directly for an employer, managed care organizations such as HMOs or PPOs, and for programs that help indigent populations.
The services that PNK offers Project Access include contracting, processing, reporting, and centralized invoicing. Because PNK agreed to work directly with participating pharmacies, Project Access was relieved of a significant administrative burden.
They provide an electronic, real-time processing system that allows participating pharmacies to instantaneously file their claims online. PNK directly bills Project Access, sending them detailed utilization reports, which are beneficial in care coordination. PNK, handles all payments to the pharmacies. Project Access, in turn, pays PNK on a bi-monthly basis.
PNK’s system captures information regarding utilization trends and expenditures. The reports provide accountability for Project Access — important since the prescription medication program is publicly funded.
The pharmacies’ contribution to Project Access is that they do not charge dispensing fees.
In addition, Project Access leverages donated medications from pharmaceutical companies on behalf of enrolled patients. This prevents spending funds for a significant amount of medications needed by patients.