Framework Focus

In this episode of Framework Focus, Dr. Dae Lee breaks down the regulatory and reimbursement shifts reshaping long-term care (LTC) pharmacy. With the Inflation Reduction Act (IRA) moving from policy theory to operational reality, Medicare’s Maximum Fair Price (MFP) program, Part D redesign, and inflation rebate enforcement are now active forces that LTC operators must navigate. This conversation moves beyond headlines and into real-world implications: cash flow risk, administrative burden, contracting exposure, and strategic readiness for closed-door and combo LTC pharmacies. Key Discussion Points Medicare Drug Price Negotiation Is Now Operational  The IRA authorizes Medicare to negotiate prices for certain high-spend Part D drugs, with the first 10 Maximum Fair Prices (MFPs) effective January 1, 2026. This marks a structural shift in federal drug pricing and directly impacts LTC dispensing economics. Maximum Fair Price and LTC Reimbursement Compression  MFP caps reimbursement on selected drugs, creating potential margin compression if acquisition costs and payment timing are misaligned. For LTC pharmacies operating on tight spreads and high-volume chronic utilization, even small deltas can materially affect profitability. Medicare Transaction Facilitator (MTF) and Payment Timing Risk  The MTF system introduces new payment mechanics between manufacturers, plans, and pharmacies. LTC pharmacies must understand how effectuation and reconciliation work, particularly if payment timing differs from traditional Part D adjudication flows. Cash flow modeling becomes essential. Administrative Complexity and Claims Reconciliation  Identifying which NDCs are subject to MFP, managing claim reversals, handling price disputes, and monitoring plan-level compliance will increase administrative workload. LTC pharmacies will need structured internal workflows to prevent reimbursement leakage. Dispensing Fees and the LTC Service Intensity Problem  Unlike retail, LTC pharmacy includes compliance packaging, emergency kits, cycle fills, consultant pharmacist oversight, and regulatory documentation. Current IRA implementation does not automatically adjust dispensing or supply fees to reflect this complexity, raising sustainability concerns. Congressional Efforts to Stabilize LTC Pharmacy  Legislative proposals such as the Preserving Patient Access to LTC Pharmacies Act aim to create supply fee protections tied to MFP drugs. The episode explores whether policy corrections are likely — and how quickly DC can realistically respond. Expansion of Negotiated Drug Lists  The initial 10 negotiated drugs are only the beginning. Additional rounds of negotiation are underway, expanding exposure across more therapeutic classes. LTC pharmacies must treat MFP as a growing structural feature — not a limited pilot. Part D Redesign and the $2,100 Out-of-Pocket Cap  Beginning in 2026, the redesigned Part D benefit changes liability distribution among plans, manufacturers, and CMS. The new out-of-pocket cap alters plan incentives and may lead to tighter utilization management, formulary shifts, and network recalibration — all of which LTC pharmacies must monitor closely. Inflation Rebates and Market Distortion  The IRA’s inflation rebate provisions penalize manufacturers for price increases above inflation benchmarks. While not directly adjudicated at the pharmacy counter, these provisions influence manufacturer pricing strategy, launch pricing behavior, and downstream PBM negotiations — indirectly affecting LTC acquisition costs. Strategic Readiness as a Competitive Advantage  The episode concludes with practical recommendations:  • Conduct an MFP exposure audit across top-dispensed NDCs  • Reassess PBM contracts and network participation clauses  • Model cash flow under delayed reimbursement scenarios  • Educate facility partners on regulatory changes  • Build internal compliance tracking specific to negotiated drugs Why This Matters Now For LTC pharmacies, this is not simply a policy conversation — it is a structural shift in reimbursement architecture. As federal oversight expands and pricing authority evolves, operational precision and legal literacy will define which organizations adapt successfully. About our guest:  Dr. Dae Lee, Pharm.D, Esq., CPBS  Shareholder - Buchanan Ingersoll & Rooney PC  Email: [email protected]  Dae Y. Lee is a pharmacist-attorney and Certified Pharmacy Benefits Specialist™ (CPBS™) who represents pharmacies, healthcare stakeholders, and plan sponsors in high-stakes disputes and regulatory matters involving Pharmacy Benefit Managers (PBMs) and government payors. Drawing on his dual training as a pharmacist and attorney, Dae focuses his practice on defending clients in audits, investigations, enforcement actions and complex reimbursement and compliance matters. Dae routinely represents pharmacies nationwide in PBM and payor audits, including Fraud, Waste and Abuse (FWA) investigations, extrapolation disputes, overpayment recoupments, credentialing denials, network suspensions and terminations. He advises pharmacies on compliance with applicable state pharmacy fair audit laws, PBM provider manuals, and reimbursement standards, with the goal of minimizing financial exposure while preserving network participation and business continuity.

Cyber threats facing long-term care pharmacies continue to evolve, putting sensitive data, systems, and patient trust at risk. In this episode of FrameworkFocus, host Todd Eury sits down with Scott Beatty, President & CEO of SoftWriters, and Chris Callahan of Echelon Risk + Cyber to explore today’s threat landscape and practical strategies to strengthen cybersecurity maturity. From leadership accountability to real-world defense tactics, discover how pharmacies can improve security hygiene and build resilience without slowing innovation.

In this episode of FrameworkFocus, we explore how artificial intelligence is reshaping long-term care pharmacy. Rick Pollick and Kyle Nilson from SoftWriters’ Alpha Labs join us to discuss the industry-wide impact of AI, the benefits and challenges it presents, and how SoftWriters is bringing innovative, AI-driven workflows to life—starting with AI Order Entry Automation.

  In this episode, host Todd Eury sits down with Terry Dean and Amanda Malooley to explore the growing importance of business intelligence in long-term care pharmacy. Together, they discuss the challenges pharmacies face in accessing and interpreting data, why real-time insight is becoming mission-critical, and how smarter visibility leads to better operational and clinical outcomes. The conversation then traces the journey behind FrameworkInsight—how it was envisioned, built, and continues to evolve to support pharmacy leaders in making informed, confident decisions.

In the final installment of our three-part series, host Todd Eury wraps up his live coverage from the 2025 FrameworkLTC Innovation Conference. Tune in for more engaging interviews with LTC pharmacy attendees, partner exhibitors, and SoftWriters team members as they reflect on the event’s biggest moments and discuss what’s ahead for the LTC pharmacy community.

In part two of our exclusive three-part series, host Todd Eury continues the conversation live from the 2025 FrameworkLTC Innovation Conference. Hear from LTC pharmacy professionals, trusted partners, and SoftWriters experts as they share their experiences, key takeaways, and perspectives on the evolving world of long-term care pharmacy.

In part one of our special three-part series, join host Todd Eury as he takes you inside the 2025 FrameworkLTC Innovation Conference. Recorded live on-site, this episode features conversations with long-term care (LTC) pharmacy leaders, partner exhibitors, and members of the SoftWriters team. Hear firsthand insights and success stories that highlight innovation, collaboration, and the future of LTC pharmacy.

In this episode of FrameworkFocus, we explore how the long-term care (LTC) market has evolved from the pre-pandemic boom through COVID-19’s sharp disruption to today’s near-recovery. Jason Yablinsky, CFO at SoftWriters, unpacks how shifting interest rates, housing liquidity, and the coming wave of Baby Boomer demand are reshaping the industry’s trajectory. Tune in to learn why today’s financial constraints may soon become tomorrow’s catalysts for growth.

In this special episode of FrameworkFocus, we’re getting you ready for the 2025 FrameworkLTC Innovation Conference—Where LTC Pharmacy Connects. You might remember it as our “User Conference,” but we’ve refreshed the name to better reflect where we’re headed. This event has always been about more than just software; it’s about accelerating innovation, sharing ideas, and shaping the future of Long-Term Care Pharmacy. Tune in as we highlight what’s new for this year, what attendees can expect, and why this event continues to be a must-attend gathering. Plus, hear from Matthew Gilbert, VP of Business Transformation and Major Accounts at RxSafe, Diamond sponsor this year, who shares insights from a vendor perspective and discusses why RxSafe is excited to participate in this year’s conference.

In this episode of FrameworkFocus, VP of Customer Success Jackie Maitland is joined by Eric Fernandez and Dustin Harbison to explore the full customer journey at SoftWriters—from first engagement through implementation, account management, and long-term growth. Together, they share how collaboration, transparency, and continuous feedback shape a partnership built for lasting success in the long-term care pharmacy space.

In this episode of FrameworkFocus™, host Todd Eury sits down with Dori Armstead, VP of People at SoftWriters, to explore The Future of Work and what it means for the pharmacy technology industry. Dori shares insights on building a talent-centric organization, SoftWriters’ journey in improving hiring and retention, and how HR strategies are evolving to meet today’s workforce demands. The conversation covers key topics like attracting and developing top talent, fostering a culture of belonging, and planning for the future through thoughtful job architecture. With a forward-looking perspective, Dori highlights the skillsets that will drive business success over the next five years and provides practical advice for pharmacy leaders looking to future-proof their workforce.   

The political landscape is shifting, and long-term care (LTC) pharmacies are feeling the impact. In this episode of FrameworkFocus, we sit down with Alan Rosenbloom, President & CEO of the Senior Care Pharmacy Coalition, to discuss the key policy challenges facing LTC pharmacies in 2025. From the effects of the Inflation Reduction Act and ongoing PBM reform efforts to the push for LTC at Home and the looming threat of NADAC payment changes, Alan breaks down what’s happening in Washington and what it means for LTC pharmacies nationwide. Tune in for expert insights on the regulatory road ahead and how the industry can advocate for meaningful change.  

Join host Patrick Hussey as he chats with Melissa Post, Director of People & Culture at SoftWriters, about tackling staffing challenges and creating a thriving workplace in long-term care (LTC) pharmacies. Melissa shares actionable strategies for recruiting and retaining top talent amid industry-wide shortages, building a strong talent bench through professional development and mentorship, and fostering a culture of engagement, inclusion, and belonging. She also offers insights into leading teams through change and effectively overcoming resistance. Packed with practical tips, real-world examples, and expert advice, this episode is a must-listen for anyone looking to help their pharmacy team thrive.

In Episode 20 of FrameworkFocus™, host Patrick Hussey, President of Pharma Dynamix Consulting, sits down with Dave Emison, Chief Commercial Officer at SDS Rx, to discuss the state of long-term care (LTC) pharmacy as we begin 2025. Together, they explore key challenges and opportunities facing the industry, including labor management, pharmaceutical acquisition, and delivery optimization. Gain actionable insights on building resilient workplace cultures, negotiating smarter distributor contracts, and implementing innovative delivery solutions to navigate financial pressures and thrive in a rapidly evolving landscape. Don't miss this forward-looking conversation with practical strategies for success in LTC pharmacy.

In this episode of FrameworkFocus, host Patrick Hussey sits down with Eric Weast, Owner of ECW Network and IT Solutions, and Robbie Macdonald, Director of Client Enablement, to explore the critical role of technology in long-term care pharmacies. They discuss the opportunities and risks of AI, strategies to combat cybersecurity threats, and the importance of a robust technology roadmap. Gain insights from industry experts on how to future-proof your pharmacy with the right tools and planning.

The recent 14th Annual FrameworkLTC User Conference hosted by SoftWriters brought together key figures from the long-term care (LTC) pharmacy industry. This year's gathering at the ARIA in Las Vegas provided a unique platform for professionals to exchange ideas, discuss the future of LTC, and share the latest industry insights. From accelerating innovation to building a sustainable future in pharmacy, the conference underscored SoftWriters' commitment to meeting the evolving needs of LTC providers and patients.

In this episode of FrameworkFocus, we sit down with media leaders Greg Cianfarani, CEO of RxInsider, and Will Lockwood, Senior Editor of Pharmacy Technology and Management Review (PTMR), to explore the latest trends shaping long-term care (LTC) pharmacy. We’ll dive into the critical topics they've covered in 2024, from technological innovations like AI and automation to emerging industry challenges. Join us for an insightful discussion on how these platforms provide value to the LTC community and what the future holds for pharmacy in the next few years. Don't miss these expert insights from the forefront of pharmacy media.  

In this insightful episode of FrameworkFocus, we welcome a special guest host, Todd Eury from the Pharmacy Podcast Network. Todd is joined by Michelle Templin, the Senior Vice President of Strategy & Legislative Affairs at Managed Healthcare Associates. Together, they delve into the ever-evolving legislative landscape and its profound impact on the Long-Term Care Pharmacy industry. From recent regulatory shifts to upcoming policy changes, Todd and Michelle provide expert analysis to help you stay ahead in a complex and dynamic environment.

In Episode 15 of FrameworkFocus, Dr. Mark Fulton sits down with Dan Castellanos from Acute Care Pharmaceuticals to delve into the critical aspects of USP 797/800 compliance. Dan shares his background and career journey before discussing the role of Acute Care Pharmaceuticals in supporting pharmacies with sterile and hazardous drug compounding. Listeners will gain insights into the importance of sterile compounding, the challenges of maintaining USP 797 compliance, and the pitfalls to avoid. Dan also explains the identification and management of hazardous drugs, highlighting the significance of USP 800 compliance. The episode wraps up with a look at future trends in USP guidelines and their environmental impact. Tune in for an informative discussion on ensuring pharmacy compliance in these essential areas.

In this episode, Dr. Mark Fulton converses with Dr. Steven Albert and Dr. Aimee Pickering from the Claude Pepper Center in Pittsburgh. The University of Pittsburgh Claude D. Pepper Older Americans Independence Center is one of fourteen Centers throughout the United States funded by the National Institute on Aging. This episode delves into the center's history, mission, and impactful research focused on senior care. Learn practical steps for long-term care providers to develop and implement de-prescribing programs and explore opportunities for collaboration with the Pepper Center. This episode offers valuable insights and practical advice for enhancing patient care in long-term care settings.

This episode of FrameworkFocus™ comes live from SoftWriters' inaugural AI Mastermind Cohort in Pittsburgh. Hear interviews with industry leaders on the transformative power of AI in pharmacy operations. Discover current applications, future innovations, and the overall impact of AI on the pharmacy industry. We invite you to dive into these thought-provoking discussions on all things AI in long-term care pharmacy.

In this episode of FrameworkFocus, we delve into the world of organizational involvement and leadership in pharmacy with Tim Fensky, Associate Director of Advanced Wellness Pharmacy. Tim shares insights from his career journey, emphasizing the importance of pharmacist engagement with professional and regulatory bodies such as State Boards, NABP, and NCPDP. Through compelling stories and lessons learned, Tim highlights the impact of organizational involvement on personal and professional growth. He offers practical advice on how listeners can get involved and make a difference in the field of pharmacy. Join us for an enlightening conversation on why organizational engagement matters and how it shapes the future of pharmacy practice.

In Episode 11 of FrameworkFocus, host Dr. Mark Fulton explores high-tech pharmacy in America's heartland with Dr. Dakin Updegraff from LifeSpan Pharmacy. Dr. Updegraff discusses his journey starting in pharmacy during the COVID-19 era, his role as an informatics pharmacist, and LifeSpan's innovative approach, including their Robotic Processing Automation team. He shares insights into emerging technologies shaping the profession and addresses key issues impacting long-term care pharmacy's future. Join us for a deep dive into the intersection of pharmacy, informatics, and cutting-edge technology.  

In this episode, Shelly Spiro, Executive Director of the Pharmacy Health Information Technology Collaborative, joins us to explore EAI and Machine Learning in LTC Pharmacy. We explore challenges facing LTC pharmacies and how AI offers solutions. We discuss how to ensure data security and privacy with AI integration. We examine barriers to adoption and ways to streamline implementation. Finally, we delve into AI's role in facilitating collaboration in healthcare and ethical considerations in AI-driven decision-making.  New boost

In episode 9 of Framework Focus, host Dr. Mark Fulton engages in a compelling conversation with P3 (5th year) students from the University of Pittsburgh School of Pharmacy: Kolbe Bien, Michelle Gonsalves, and Braidon Lape. This episode delves into the background of the guests, exploring their motivations for pursuing a career in pharmacy. The discussion covers the evolution of their perspectives on pharmacy throughout their five years of education, the challenges of balancing coursework, experiential learning, and personal life, and their insights into intriguing and challenging aspects of pharmacy practice. Host: Mark Fulton  Guests: Kolbe Bien  Michelle Gonsalves  Braidon Lape

In Episode 8 of FrameworkFocus, Dr. Mark Fulton interviews TJ Griffin, Chief Clinical Officer at PharMerica, in a fast-paced exploration of the LTC pharmacy landscape in 2024. PharMerica is a national leader in pharmacy services, serving our partners in over 3,100 long-term care, senior living, IDD/behavioral health, home infusion, specialty pharmacy, and hospital management programs. In this conversation, the pair dive into the workforce challenges faced by LTC pharmacies. Griffin explores the advancements in pharmacy practice, including an expanded scope and additional opportunities for pharmacies.  Host: Dr. Mark Fulton &  Guest: TJ Griffin, Chief Clinical Officer, Pharmerica  

In this episode of Framework Focus, host Dr. Mark Fulton engages with Jean Hall and Brandi Van Patton from LogiCoy to unravel the significance of Prescription Drug Monitoring Programs (PDMPs) in Long-Term Care Pharmacy. Explore how PDMPs contribute to preventing diversion, ensuring patient safety, and addressing the opioid crisis. The episode delves into the specific impact of PDMPs on LTC, covering transitions of care, collaboration among providers, and the evolving role of LTC in this space.  The episode concludes with practical advice for pharmacies on navigating PDMPs.  Host: Dr. Mark Fulton & Guests: Jean Hall, Program Director, PDMP Solutions, Logicoy & Brandi Van Patton, Pharmacy Informatics, Logicoy  

This is part one of the three-part FrameworkLTC User Conference Post-Show series. This series is hosted by the Pharmacy Podcast Network’s own Todd Eury. In this series, Todd chats with SoftWriters’ team members, exhibitors, partners, and conference attendees live from the show floor. This episode features Aaron Nalick, Matt Lewis, Paula Carlock, Simon Beeny, and Scott Beatty. 

In this episode, Mark Fulton is joined by Paul Shelton, President of PharmaComplete Consulting Services and CEO of LTC@Home Pharmacy Network. Paul shares his career journey, leading us to an exploration of LTC pharmacy. We delve into the motivations driving independent pharmacies to enter the LTC space, discussing how to get started, market identification, staffing and equipment requirements, and service delivery to LTC facilities. Paul also highlights the unique challenges faced in LTC pharmacy and opportunities it offers, along with advice for both newcomers and those already involved in LTC. 

This is part two of the three-part FrameworkLTC User Conference Post-Show series. This series is hosted by the Pharmacy Podcast Network’s own Todd Eury. In this series, Todd chats with SoftWriters’ team members, exhibitors, partners, and conference attendees live from the show floor. This episode features Joshua Porter, Grace Ball, Julie Martin, Matt Gilbert, and Nick Majors. 

This is part one of the three-part FrameworkLTC User Conference Post-Show series. This series is hosted by the Pharmacy Podcast Network’s own Todd Eury. In this series, Todd chats with SoftWriters’ team members, exhibitors, partners, and conference attendees live from the show floor. This episode features Mark Fulton, Cara Whipple, Dan Kennedy, Karen Sims, and Derek Taylor. 

In the latest installment of FrameworkFocus, join Dr. Mark Fulton and special guest Ted Sullivan of Advasur, as they discuss the current state of the Drug Supply Chain Security Act.  Learn about the FDA’s recent announcement delaying the enforcement of several key provisions of DSCSA, how this delay will impact your pharmacy, and pathways for compliance. Plus, a bonus segment with Jennie Lee, the Pharmacy Manager at PharmaCare Hawaii, who is a customer of both Advasur and FrameworkLTC!   

In this episode, host Mark Fulton and guest Patrick Hussey talk about emerging trends in pharmacy and what the future will look like for LTC pharmacy operators. They highlight both new opportunities and challenges from a regulatory, technological and practice evolution perspective.

ComputerTalk's Maggie Lockwood previews SoftWriters' 13th annual FrameworkLTC User Conference. On this roundtable discussion, the team from SoftWriters discuss the theme of "Build, Partner, Serve." In addition, hear from a FrameworkLTC customer talk about the benefits of attending this event.   • Aaron Nalick, Director, Partnerships • Mark Fulton, Director, Product Regulatory Compliance • Daniel Green, Director of Long-Term Care, Alps Pharmacy • Dustin Harbison, Director of Account Management. Hosted by Maggie Lockwood, Director of Production at ComputerTalk. 

In this episode of FrameworkFocus, we delve into the world of regulatory compliance in long-term care with experts Donna Adendorff & Jamie Butler from The Compliance Store. This valuable resource supports skilled nursing facilities in meeting regulatory requirements efficiently. We explore the collaborative efforts required to achieve and maintain compliance, discussing its crucial impact on LTC quality. We also address post-COVID-19 challenges, staffing issues, payment concerns like PDPM, and the complexities of operations in LTC. 

In this episode, we dive into the fascinating world of delivery in long-term care pharmacies. Discover why delivery in LTC is unique and how it has become an integral component of these specialized pharmacies. Mark is joined by special guest Gibran Ameer, the CEO of Virtue Technologies. Gibran shares how his company assist LTC pharmacies in optimizing their delivery processes. They also delve into the challenges and opportunities involved in LTC delivery, all while highlighting the importance of tracking and data integration. 

On this episode, we introduce Framework Focus, a brand-new podcast that connects the Long-Term Pharmacy ecosystem, hosted by FrameworkLTC's very own Dr. Mark Fulton. In this conversation, Mark shares with Todd a little bit about the podcast and what to expect in the months to come. He also previews the FrameworkLTC User Conference happening this Fall in Boston.