Using FrameworkLTC to Track and Manage Maximum Fair Price (MFP) Impacted Claims

Beginning January 1, 2026, the Center for Medicare and Medicaid Services (CMS) will implement the Maximum Fair Price (MFP) model under the Inflation Reduction Act (IRA), affecting reimbursement for the first 10 high-cost Medicare Part D drugs. These changes will significantly impact how LTC pharmacies process claims, track estimated SDRA payments, and manage reimbursement reporting. We've added MFP-tracking functionality to FrameworkLTC to ensure your pharmacy can monitor, report on, and manage billing reconciliation of MFP-impacted claims directly in FrameworkLTC.

In this webinar, our team will walk you through MFP functionality so you can train your staff and establish an MFP tracking process to ensure your pharmacy is staying ahead of MFP-impacted claims rather than playing catch-up. Learn directly from the FrameworkLTC Product Team as they host a live webinar to walk through everything included in FrameworkLTC v3.3.349, including:

Join the Webinar to Learn:

• How FrameworkLTC detects and displays MFP-eligible claims
• Estimated SDRA amounts (Standard Default Refund Amounts) across Rx Entry, Claim Review, and Claim History
• New MFP Claims report for identifying, summarizing, and quantifying financial impact
• Enhanced billing workflows for SDRA reconciliation in Sage 300 and 3rd-party billing
• System settings required to ensure correct MFP revenue calculations

We strongly encourage you to upgrade to this new version and join our webinar to create and train your team on a process for managing MFP-impacted claims dispensed by the pharmacy. Unable to join live? Register to watch the webinar on-demand at your convenience.