The implementation of Medicare’s Maximum Fair Price (MFP) program under the Inflation Reduction Act has introduced one of the most operationally significant changes to pharmaceutical reimbursement in decades, one that has important ramifications for 340B stakeholders. While the policy debate surrounding drug pricing reform has focused on affordability and manufacturer obligations, the first months of real-world execution reveal a different and equally important issue: the 340B’s industry’s operational infrastructure may not yet be prepared to support the complexity of large-scale price coordination, reconciliation, and dispute management.

Since January 2026, RxParadigm has supported health systems, federally qualified health centers (FQHCs), pharmacies, and other stakeholders participating in MFP effectuation through its Tungsten+PLUS™ platform. Originally developed as an end-to-end rebate administration and claims reconciliation platform, the technology has been adapted to support Medicare MFP workflows, including claims qualification, payment validation, overpayment management, dispute tracking, and reconciliation.

Because the platform processes operational data across multiple stakeholder groups — including covered entities (CEs), pharmacies, manufacturers, wholesalers, and third-party administrators (TPAs) — the emerging trends provide insight into how the MFP dispute environment is evolving. Read More >