Podcasts about dae lee

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: dae.lee@bipc.com  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.

Send us a textSchedule an Rx AssessmentWhat happens when GLP-1 compounding, TrumpRx, and PBM audits all collide in your pharmacy?In this episode of the Bottom Line Pharmacy Podcast, hosts Austin Murray and Bonnie Bond, CPA, are joined by healthcare attorney Dae Lee of Buchanan Ingersoll to unpack the fast-moving legal and regulatory landscape around GLP-1s, PBMs, and audits—and what independent owners need to be doing right now to protect their businesses.We cover: - The vertical integration behind the “big three” PBMs and their rebate aggregators- Why PBM audit triggers and the realities of today's audit tactics- A practical roadmap for responding to an audit- What “recredentialing season” really means- TrumpRx And more!More About Our Guest:Dae Y. Lee, Pharm.D., Esq., CPBS focuses on representing pharmacies in their dealings against Pharmacy Benefit Managers (PBMs). With extensive experience in the intricacies of PBM audits, investigations, network enrollment, network suspension, network terminations, reimbursement disputes, and DEA as well as other governmental investigations, Dae has become a trusted advisor to a broad cross-section of pharmacies and pharmacy providers, including community retail pharmacies, chain pharmacies, compounding pharmacies, specialty pharmacies, mail order pharmacies, home infusion providers, and dispensing physician practices.. His practice also extends to assisting other stakeholders in the pharmacy industry such as wholesalers, manufacturers, and other healthcare providers. In addition to his PBM-focused work, Dae represents entities in pharmacy-related transactions and assists clients with corporate formation, due diligence, licensing, change-of-ownership requirements and credentialing, providing comprehensive legal support throughout the transaction process. Dae is a Certified Pharmacy Benefits Specialist™ (CPBS™). Offered through TransparentRx and accredited by the University of Kentucky School of Pharmacy, the CPBS program is designed to cover complex topics of pharmacy benefit management in order to provide a foundational knowledge required for higher-level evaluation of PBM business operations, fundamentals of PBM pricing, plan design, cost-containment strategies, PBM contracts, PBM procurement, Specialty Pharmacy benefits management, and overall PBM performance with emphasis on cost effectiveness.Stay connected with Dae and Buchanan, Ingersoll, & Rand: Dae Lee LinkedInBuchanan, Ingersoll, & Rand WebsiteBuchanan, Ingersoll, & Rand LinkedInBuchanan, Ingersoll, & Rand TwitterBuchanan, Ingersoll, & Rand FacebookStay connected with us on social media:FacebookTwitterLinkedInMore on this topic:Podcast: The Startup Compounding Pharmacy PlaybookPodcast: The Trusted Pharmacist: Advocacy and Building a Resilient PharmacyPodcast: From Counter to Capitol

Dae Lee, PharmD, Esq, CPBS, and Lucas Morgan, Esq, joined Over the Counter to discuss both state and federal PBM reform heading into the new year.

Can a small biotech change cancer care—and turn a profit? Paul Romness, CEO of OS Therapies, shares how his five-person team took on one of the deadliest pediatric cancers, went public, and might just shake up the system. From biologics to Wall Street, this one's got it all. Sponsored by Dae Lee of Buchanan.

I sat down with attorneys Dae Lee and Adam Farkas to dig into the legal mess surrounding GLP-1 compounding, PBM overreach, and the brutal reality facing independent pharmacies. Dae's a pharmacist-attorney, Adam's a legal powerhouse, and together they're helping pharmacies fight back in a system stacked against them.

On this episode, Dae Lee, Pharm.D., Esq., CPBS , and Harini Bupathi, Esq, attorneys at Frier Levitt, engage in a thought-provoking conversation on the evolving landscape of pharmacy benefit manager (PBM) audit strategies, regulations, and enforcement. The discussion covers notable trends in PBM audit strategies, challenges and opportunities for pharmacies in 2024. Key Takeaways PBM audit strategies are continually evolving, and pharmacies should stay vigilant in adapting to emerging trends. The challenges and opportunities for pharmacies in 2024 are intricately linked to the dynamic regulatory landscape surrounding PBMs. Proactive measures, robust compliance programs, and thorough documentation are essential components for pharmacies to minimize risks and disruptions. Pharmacies should be mindful of common pitfalls when engaging with regulatory bodies post-PBM audit.

La Señora Fátima Sanchez nos visito para compartir su historia. Nos cuenta que esta pidiendo apoyo de la comunidad que hagan boicoteo de Alvarado Bakery ya que ella fue victima de acoso sexual múltiples veces y no ha recibido el apoyo. También pide que la comunidad mande correos electrónicos exigiendo que el presidente de la compañía ponga un alto a la situación donde ella trabaja. El presidente es Dae Lee y su correo electrónico es dae@alvaradostreetbakery.com. Es importante ser respetuosxs si deciden mandar correos. #sexualassault #acososexual #panaderia #petaluma --- Support this podcast: https://podcasters.spotify.com/pod/show/rafael-vazquez7/support

In episode 52, Dae-Lee encourages you to make the most of every moment.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 51, Dae-Lee reminds us that as a bridge-building leader optimism is a must.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 50, Dae-Lee implores us to let love empower us as we lead.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 49, Dae-Lee reminds us that learning is a forever journey.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 48, Dae-Lee dives into the impact our thoughts have on our impact.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 47, Dae-Lee challenges the legitimacy of what we say we love and value.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 46, Dae-Lee focuses on the role of difference in making a difference.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 45, Dae-Lee shakes up a common quote and adds a little bit of optimism to how we hope.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 44, Dae-Lee encourages us all to choose to make today its best.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 43, Dae-Lee emphasized the importance of understanding what we all have the power to change.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 42, Dae-Lee encourages all of the perfectionists out there to focus on progression.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 41, Dae-Lee challenges our love for others by measuring our desire to see them treated fairly.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 40, Dae-Lee emphasizes the importance of remaining focused on hope through pain.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 39, Dae-Lee channels The Notorious BIG and emphasizes that dreams don't work unless people do.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 38, Dae-Lee reminds us that people are what's most important.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 37, Dae-Lee implores us to move beyond our fears and forgive.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 36, Dae-Lee reminds us of the key role communication plays in leading as a bridge-builder.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 35, Dae-Lee channels the 90's classic film Field of Dreams to remind us that many will be late to the party, but that shouldn't deter us from getting to work.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 34, Dae-Lee emplores us as bridge-building leaders to be aware of the impact of what we consume.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 33, Dae-Lee reminds us that competence for a bridge builder is a continuous journey.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 32, Dae-Lee reminds us that release is a necessary part of growth.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 31, Dae-Lee zooms in on the hope that exists because of the reality of division.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 30, Dae-Lee reminds us that progress is a team effort.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 29, Dae-Lee explores how knowing your own value impacts how you value others.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 28, Dae-Lee implores us all to welcome others as we create space.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 27, Dae-Lee doesn't overcomplicate the simple importance of choosing to do good.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 26, Dae-Lee reminds us of our opportunity to love.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 25, Dae-Lee keeps it simple about the need to love oneself.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 24, Dae-Lee reminds us that no one is perfect and could use some grace.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 23, Dae-Lee challenges us to be the stopgap that others desperately need.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 22, Dae-Lee encourages us to be love in an effort to create less space for hate.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 21, Dae-Lee reminds us what empathy is all about.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 20, Dae-Lee reminds us that the journey has so much to offer.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 19, Dae-Lee challenges us to take an extra step beyond just being honest or "keeping it real".Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 18, Dae-Lee reminds us that feelings are important but should not deter us from doing what's right.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

This episode revolves around a moment I honestly wish had never happened. Because that moment, in and of itself, was just the beginning of an incredibly difficult journey for a family I care very much about. But as you'll eventually realize, it's actually a moment to be grateful for -- because of what it's done for the soul, how it's helped find lasting peace, and how it's led to such a beautiful personal transformation.I'd like to introduce you to a long-time friend of mine, Andrew Dae Lee. And, I'd like to share with you his journey towards becoming ready to "just be" and to allow himself to truly experience everything life has to offer. I find it to be both introspective and inspirational, and I'm certain you'll feel the same.--If you're new to this podcast, welcome home! To see about working together, and collaborating on some personal (and professional) development work, feel free to connect with me on LinkedIn or on our website bayhaus/creative.

In episode 17, Dae-Lee reminds us that what we do as leaders will influence what happens around us.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 16, Dae-Lee encourages the stalled-out leader to tackle the small things.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon. 

In episode 15, Dae-Lee challenges leaders to find the little opportunities to be thankful while working towards large visions. Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon. 

In episode 14, Dae-Lee challenges us all to be active on the frontlines we have been positioned for. Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 13, Dae-Lee reminds us that change is not rooted in policies but in people.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 12, Dae-Lee emphasizes the importance of listening to learn as we care for those around us.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon

In episode 11, Dae-Lee focuses on how we may allow the approval of others to keep us from taking the risks necessary to make progress.Don't forget to subscribe!Join the Bridge Builder Email List and stay in the know.Connect On Social:InstagramFacebookLinkedInPatreon