VENTEGRA ANNOUNCES ITS MEDICAL BENEFIT MANAGER (MBM) PHARMACY SERVICES ADMINISTRATION (PSA) CONTRACTS TOP 100; HELPS CLIENTS GAIN EFFICIENCIES, IMPROVE QUALITY OF CARE, AND LOWER COSTS
Ventegra Celebrates 7 Years as the First New Class-of-Trade Created in the Last 40 Years - Designation Recognized by Pharma
GLENDALE, CA –Ventegra, Inc., a Medical Benefit Manager (MBM), which includes a Pharmacy Services Administration (PSA) program, today announces that its roster of MBM clients has topped 100, greatly fortifying Ventegra leadership as both the first and largest U.S.-based, legally recognized and configured MBM in the nation.
Ventegra CEO Robert T. Taketomo, Pharm D, MBA, says, "We are proud that Ventegra
is recognized by the pharmaceutical industry as the first entity operating with an MBM
business model. Ventegra's MBM new class-of-trade designation allows the industry to
work with Ventegra in ways that are separate and distinct from traditional PBMs and
GPOs and consistent with various regulatory safe harbors."
A crucial cornerstone of this industry shift is that the MBM business model enables all
drugs to be covered under a single integrated healthcare benefit vs separate billing for
medical drugs and pharmacy drugs. As a result, the model reduces fragmentation,
increases integrity, integrates population health, and improves utilization management.
Ventegra's MBM status ensures the delivery of innovative solutions for cost-efficient
pharmaceutical services that maximize benefits for payors, providers, and patients,
unlike Pharmacy Benefit Managers (PBMs) and Group Purchasing Organizations
(GPOs). By using the MBM model, payors of healthcare in all market segments reap
benefits that include administrative simplification, efficiencies, and increased quality of
care fueled by the highest integrity and transparency standards in the marketplace.
Explaining Ventegra's Medical Benefit Manager "difference," Dr. Taketomo says, "We
have zero conflicts of interest unlike many PBMs that require members to use PBMowned
mail order or specialty pharmacies or that move their rebate contracting
operations offshore to other countries. The tremendous recognition and support by the
industry and our clients to this new discount channel continues to fuel Ventegra's
passion for making a meaningful difference in the health of the community that we
serve."
In 2014, after extensive legal review, Ventegra received contractual designation from
one of the largest pharmaceutical companies in the world as the first entity operating as
an MBM, making it a new class-of-trade. The significance of this recognition is
underscored by the fact that the last new class-of-trade in the industry was created over
40 years ago with the introduction of the Pharmacy Benefit Manager (PBM) class-oftrade.
By December 2019, almost all Ventegra agreements had placed Ventegra into
this new class-of-trade, thus representing a significant milestone in the continued
evolution of healthcare delivery in the United States.
With the MBM model, clients have the assurance that they will have access to discounts
that may be unavailable to other current classes-of-trade such as PBMs and GPOs. The
MBM PSA solution can deliver all the functionality of a PBM with more integrity,
transparency, and significant cost savings, while improving overall quality of care. For
instance, with our patented Acquisition Cost Index, the amount billed by pharmacies is
reflected and verifiable in the invoice detail paid by the payor, rather than being simply
'passed through' before adding ancillary charges.
Dr. Taketomo uses the analogy of an electric car to illustrate the MBM model. "Like the
comparison between an electric engine and a traditional gas engine, Ventegra can
power the same solution as a PBM, but we do it more efficiently and ethically by being
patient-focused rather than being driven by fiduciary obligations to shareholders."
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About Ventegra, Inc.
Ventegra uses innovative and proprietary programs and products to ensure appropriate
use of prescription drugs while lowering our clients' costs. As a Medical Benefit
Manager (MBM), Ventegra is a new class-of-trade healthcare model that helps clients
gain efficiencies, lower expenditures, and improve the overall quality of care.
Ventegra's offerings include innovative, cost-saving solutions designed for medical
groups, health systems, self-insured plans, TPAs, government entities, brokers,
consultants, and nonprofits. www.ventegra.com
Our drug list and formularies are designed to provide our clients with a choice of pharmacy products that meet all of the essential clinical conditions while addressing economic needs, and providing quality of care, affordability and choice.
Ventegra was founded to create balance between profitability and affordable patient care in an industry burdened by misplaced priorities. Our team applies our core values of integrity and transparency to create new healthcare delivery channels that are more consolidated and efficient. We channel our resources to positively impact the lives of others and create value for society as a whole.
Policies
HIPAA Compliance Policy
Ventegra has adopted a General HIPAA Compliance Policy in order to comply with the Health Insurance Portability and Accountability Act (“HIPAA”), as amended by the Health Information Technology for Economic and Clinical Health (“HITECH”) Act of 2009 (Title XIII of division A and Title IV of division B of the American Recovery and Reinvestment Act “ARRA”) and the HIPAA Omnibus Final Rule (Effective Date: March 26, 2013). We acknowledge that full compliance with the HIPAA Final Rule is required by or before September 23, 2013.
Ventegra hereby acknowledges our duty and responsibility to protect the privacy and security of Individually Identifiable Health Information (“IIHI”) generally, and Protected Health Information (“PHI”) as defined in the HIPAA Regulations, under the regulations implementing HIPAA, other federal and state laws protecting the confidentiality of personal information, and under principles of general and professional ethics. We also acknowledge our duty and responsibility to support and facilitate the timely and unimpeded flow of health information for lawful and appropriate purposes.
This policy governs general HIPAA Compliance for Ventegra. All personnel of Ventegra must comply with this policy. Demonstrated competence in the requirements of this policy is an important part of the responsibilities of every member of our workforce. Officers, employees, Business Associates, contractors, affected vendors, temporary workers, and volunteers must read, understand, and comply with this policy in full and at all times.
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Effective Date: March 1, 2021
This privacy notice discloses the privacy practices for www.ventegra.com. This privacy notice applies solely to information collected by this website, except where stated otherwise. It will notify you of the following:
What information we collect;
With whom it is shared;
How it can be corrected;
How it is secured;
How policy changes will be communicated; and
How to address concerns over misuse of personal data.
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If you feel that we are not abiding by this privacy policy, you should contact us immediately via telephone at 858-551-8111 or info@ventegra.com.
Fraud, Waste & Abuse
Part of our efforts to improve the healthcare system, Ventegra is committed to detecting, preventing and correcting fraud, waste and abuse.
What are Fraud, Waste, and Abuse?
FRAUD is generally defined as knowingly and willfully executing, or attempting to execute, a scheme or artifice to defraud any health care benefit program or to obtain (by means of false or fraudulent pretenses representations, or promises) any of the money or property owned by, or under the custody or control of, any health care benefit program. (18 U.S.C. § 1347)
WASTE is overutilization of services or other practices that, directly or indirectly, result in unnecessary costs to the health care system, including the Medicare and Medicaid programs. It is not generally considered to be caused by criminally negligent actions, but by the misuse of resources.
ABUSE includes any action(s) that may, directly or indirectly, result in one or more of the following:
Unnecessary costs to the health care system, including the Medicare and Medicaid programs
Improper payment for services
Payment for services that fail to meet professionally recognized standards of care
Services that are medically unnecessary
Abuse involves payment for items or services when there is no legal entitlement to that payment.
How to Report Fraud, Waste, and Abuse
If you suspect fraud, waste, or abuse in the healthcare system, please report it. To report suspected fraud, waste, or abuse, you can contact Ventegra:
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Ventegra, Inc.
450 North Brand Blvd
Suite 600
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