Mediledger Network.

Blockchain Powered Network in the Life Science Industry

Mediledger Network

The MediLedger network prioritizes industry alignment, accuracy, privacy, and decentralization. Network member trading partners find a unified view of transaction-related data, automatically enforced accuracy, control over private data, and a decentralized network that allows for direct transacting with no intermediary.

About the Project

Currently, there is uncertainty on how to manage 340B-based eligibility with the recent shifts in the approach to Contract Pharmacies.

There are significant gaps in communicating 340B Contracts as it requires significant manual work to maintain 340B Covered Entities.

Several Manufacturers utilise specific avenues to determine if a Contract Pharmacy should be identified as an exception.

The lack of an automated system to ensure accuracy and efficiency in real time has inefficiencies in the current adjudication process.

The MediLedger 340B Eligibility Solution will help Manufacturers manage and communicate exhaustive 340B Eligibility, including Contract Pharmacies, providing the Wholesaler with complete confidence in the eligible customers and chargeback submissions.

MediLedger can help automatically consume these documents that signify a Contract Pharmacy as an exception and display this in the UI, impacting eligible contracts downstream.

Once 340B contracts have been communicated accurately, MediLedger will enforce 340B specific adjudication rules at the ZKP layer to ensure 340B chargeback claims are adjudicated accurately in real-time.

MediLedger will facilitate a Manufacturer user to configure eligibility rules for 340B contracts in the node.

About the Company

Automating transactions in healthcare with blockchain.

Balancing Growth

Navigating the Complexities of 340B.

This has led to an escalating issue of manufacturers paying out Medicaid rebate claims on drugs where a 340B discount was already applied, also known as a duplicate discount. 
Multiple pharmaceutical manufacturers have now put in place Medicaid claim requirements and/or 340B discount restrictions in an effort to solve the duplicate discounts problem.

Annual spend (340B)

in the last 10 years

Annual spend (340B)

in the last 10 years

Healthcare providers are now facing a growing list of unique requirements from different drug manufacturers that seems unsustainable, and could increase administrative burden and decrease drug access to eligible patients.

Participants

Pharmaceutical 

Manufacturers

Covered Entities under the section 340B(a)(4) of the Public Services Act

State & Federal Agencies administering 340B/Medicaid Programs

Scope Of Work

This project went through all stages of the design process.
This significantly improved the quality of deliverables.

340B Eligibility
Summary

Currently, there is uncertainty on how to manage 340B-based eligibility with the recent shifts in the approach to Contract Pharmacies. Even without Contract Pharmacies, there are significant gaps in communicating 340B Contracts as it requires significant manual work to maintain 340B Covered Entities. This can drive misalignment on eligible customers, leading to chargeback disputes and increased reconciliation time.

Future State
Summary

The MediLedger 340B Eligibility Solution will help Manufacturers manage and communicate exhaustive 340B Eligibility, including Contract Pharmacies, providing the Wholesaler with complete confidence in the eligible customers and chargeback submissions. MediLedger Claims & Credits will also enforce 340B specific adjudication rules to ensure chargeback claims are adjudicated accurately and efficiently.

An existing integration empowers each feature to the HRSA database which includes both Covered Entities and Contract Pharmacies.

Contract Pharmacy
Exception Management

MediLedger will provide a UI to help identify Contract Pharmacy exceptions from the entire list of Contract Pharmacies provided by HRSA. These exceptions can be managed at a global or contract level.
This will allow a Manufacturer user to denote specific Contract Pharmacies as exceptions, which are then placed into specific contracts and then communicated using MediLedger Contract Communication.

This will help to significantly reduce the manual work and coordination required to maintain and communicate exception Contract Pharmacies by utilizing a centralized streamlined location.

Contract Pharmacy
External Integrations

Several Manufacturers utilize specific avenues to determine if a Contract Pharmacy should be identified as an exception. These can be applications or documents submitted by the pharmacy itself or an external source such as 340B ESP.


MediLedger can help automatically consume these documents that signify a Contract Pharmacy as an exception and display this in the UI, impacting eligible contracts downstream.

Contract Eligibility
Determination

MediLedger will facilitate a Manufacturer user to configure eligibility rules for 340B contracts in the node. For example, these rules can be based on COT or Market Segment.

Once Contract Pharmacy exceptions have been identified, MediLedger will automatically run the configured Contract Eligibility rules against the entire HRSA database and the Contract Pharmacy exception list.

This will construct an exhaustive contract eligibility list for each 340B contract and communicate said contract to all applicable wholesalers. MediLedger will consistently maintain the eligibility list as changes occur in the HRSA database.

340B contract eligibility will no longer have room for misalignment between trading partners; Wholesalers will know precisely which Covered Entities and Contract Pharmacies are eligible for chargebacks. 


This removes the need for Manufacturers to maintain the HRSA database records in their current RM/ERP system.

Chargeback
Adjudication

Once 340B contracts have been communicated accurately, MediLedger will enforce 340B specific adjudication rules at the ZKP layer to ensure 340B chargeback claims are adjudicated accurately in real-time. For example, MediLedger can enforce that 340B IDs are provided for Contract Pharmacies and that there are exact address matches for a claim to be approved.

This will allow Manufacturers and Wholesalers to focus on legitimate disputes and managing the membership processes.

Roaster Management

HIN, DEA, 340B and other industry datasets are integrated and accessible to all participants uniformly.
As new customers & locations are added to a roster, they are be automatically validated against industry data before trading partners receive them.
Build automation into maintaining and auditing your customer master data.
New GPO member and location updates are shared in real-time.
GPO Rosters stay synced between all trading partners.
GPO Documentation managed and shared directly in MediLedger node.

Rapid and Powerful
Customer Research

View current and historical states of a customer directly with in your MediLedger node.

View current and historical states of a customer directly with in your MediLedger node.

View current and historical states of a customer directly with in your MediLedger node.

View current and historical states of a customer directly with in your MediLedger node.

Contract
Communication

Contract updates, validated by blockchain, provide predictability to wholesalers.

Pricing, product,
customer and other contract updates are shared in real-time.

Pricing, product,
customer and other contract updates are shared in real-time.

Pricing, product,
customer and other contract updates are shared in real-time.

Easily search and filter through contract headers, products, and customers.

View historical states of a contract every time an update occurs through a history timeline.
Current/historical contract states are always aligned between trading partners, allowing dispute resolution in seconds.
Replace EDI 845 with a single connection point for all current and future trading partners.
MediLedger gives you control over the data you receive, enforcing your rules in your trading partner’s system.
The MediLedger Network is decentralized meaning you are connected directly with your trading partner, and have complete control over your data, no 3rd parties involved.

Wireframes

In the dynamic landscape of healthcare management, accuracy and efficiency are paramount. Given the complexity of the project, it was clear that a solution was needed to streamline processes and ensure accuracy.
Wireframes were instrumental in the development for several key reasons.

Clarity in Conceptualization

The complex nature of managing the MediLedger project required a clear visualisation of the solution’s structure and functionality. By creating wireframes, we provided stakeholders with detailed insights into the navigation flow, feature placement and hierarchy, giving them a comprehensive understanding of the solution’s structure.

User-Centric Approach

Each wireframe was meticulously crafted with the end-user in mind, ensuring intuitive navigation and optimal user experience.

Iterative Process

Creating wireframes facilitated an iterative design process, enabling the refinement of concepts before moving into full-scale development.

Style Guide

Graphik is a neo-grotesque sans-serif typeface designed by Christian Schwartz and published by Commercial Type in 2009. The low contrast and large x-height give the typeface great versatility. It is suitable for display purposes as well as for text sizes, captions and for such specific tasks as navigation systems and map-making.

abcdefghijklmnopqrstuvwxyz

abcdefghijklmnopqrstuvwxyz

0123456789

#0B1641
#003090
#017EFA
#00E8E8
#00A8F3

Visual Design

This phase ensured an intuitive and visually appealing platform that was seamlessly aligned with user expectations and nee

Chargebacks

Chargeback accuracy enforced against contract/invoice data inside wholesaler’s system – through blockchain.

Auto-adjudication of chargebacks through MediLedger can speed up payment cycles. Exceptions to established rules can be easily handled through elegant approval processes.

Adjudication Details

With MediLedger Claim Adjudication, wholesalers are enabled with manufacturer business rules that automatically enforce accuracy and adjudicate chargebacks right inside a wholesaler’s system.

Invoice Details

Returns, credits, re-bills handled automatically in wholesaler’s system, and aligned between all trading partners in real-time.

Automatically generates credit note based on adjudicated chargeback.

Link between invoice, chargebacks, resubmissions and credit memos permanently maintained.

Conclusion and Impact

The implementation of the MediLedger 340B Eligibility Solution marks a significant advancement in the management and communication of 340B Eligibility, particularly concerning Contract Pharmacies. By automating the processing and display of key documents and exceptions, MediLedger provides a streamlined, accurate approach to handling eligibility which significantly reduces manual workload and potential for error. Furthermore, the introduction of real-time adjudication rules at the ZKP layer ensures that 340B chargeback claims are processed accurately and efficiently.

This solution not only boosts operational efficiency but also enhances compliance and trust between manufacturers, wholesalers, and contract pharmacies. The successful deployment of the MediLedger project is set to transform the 340B landscape, providing all stakeholders with the tools needed for seamless, transparent transactions and fostering a more reliable 340B program environment.

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