VENTEGRA ANNOUNCES THE SUCCESSFUL IMPLEMENTATION OF THE NEW VENTEGRA SPECIALTY INCLUSION (VSI) PROGRAM
VSI Program Utilizes Ventegra's Clinical Infrastructure to Develop and Maintain an Evidence-Based Approach to Evaluating New Drugs for Formulary Inclusion
GLENDALE, CA –Ventegra, Inc., a Medical Benefit Manager (MBM) that delivers innovative, cost-efficient pharmaceutical and healthcare solutions to payors, providers, and members, today announced the successful implementation of the Ventegra Specialty Inclusion (VSI) program to maintain broad access for payors, providers, and members to beneficial medications at an affordable cost.
The VSI program underscores Ventegra's clinical infrastructure and heritage as a company managed and operated predominantly by healthcare professionals, pharmacists, and certified pharmacy technicians.
Mark Shinmoto, Pharm.D., Chief Pharmacy Officer, says, "The Ventegra Specialty Inclusion (VSI) program's capability is a vital and important new tool in Ventegra's ability to appropriately manage the utilization of the plethora of drugs being brought to market. It allows us to ensure that drugs with sufficient clinical effectiveness data (e.g., drugs that will be useful to the population served in actual practice) are available for members and payors."
Explains Dr. Shinmoto, "This mitigates the probability of members being prescribed drugs with limited evidence of benefit, while we continue to gather information on these products for clinical value."
In addition, a key benefit of the VSI program is its guidance to the pharmaceutical industry to provide evidence of clinical effectiveness. The FDA's initial drug approval process is based on evidence of safety and efficacy and lacks the key findings of clinical effectiveness.
Robert T. Taketomo, Pharm.D., MBA, President/CEO, explains, "The Ventegra Specialty Inclusion program reflects the clinical focus of Ventegra and our deep commitment to member care and managed care principles. Our MBM solution provides a rational and alternative approach to managing prescription drugs that doesn't automatically add every drug brought to market for coverage and expense to a payor's benefit program."
Adds Dr. Taketomo, "Our unique societal perspective on healthcare as we continue our transition into a nonprofit entity ensures that our stakeholders and community that we serve receives the right balance of access to medications, quality of care and cost. Our approach strives to maintain broad access to beneficial medications at an affordable cost for our members and payors. It is a difficult balance that is a core strength of Ventegra."
Ventegra remains the only Medical Benefit Manager that is transitioning into a nonprofit structure to ensure sustainability for the community it serves. It is managed and operated largely by pharmacists and pharmacy technicians with a focus on providing an evidence-based approach to prescription drug coverage in both medical and pharmacy benefit programs. Unlike most traditional pharmacy benefit managers, Ventegra does not have any fiduciary commitment to shareholders and exists to serve and benefit its community.
For more information, please contact Dr. Shinmoto at mark@ventegra.org.
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About Ventegra, Inc.
Ventegra, Inc. is the legacy Ventegra that is dedicated to servicing Ventegra Foundation. A complex transition process has begun, and over time, Ventegra, Inc.'s mission will be fully assumed by Ventegra Foundation.. www.ventegra.org
About Ventegra Foundation
Ventegra Foundation is a California Nonprofit Public Benefit Corporation. Its mission is to establish new channels for delivering better efficiencies and more cost-effective healthcare for the community that is served. Ventegra Foundation is expected to be fully operational by June 30, 2024. www.ventegra.org
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.
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Effective Date: March 1, 2021
This privacy notice discloses the privacy practices for this site. This privacy notice applies solely to information collected by this website, except where stated otherwise. It will notify you of the following:
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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 privacyandsecurity@ventegra.org.
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.
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