What is 340B?
The 340B drug pricing program is a federal drug discount program established in 1992 intended to permit covered entities to stretch scarce federal resources to reach as many eligible patients as possible and provide comprehensive, high-quality services. This is done by enabling these health systems to purchase “covered” outpatient medications at significantly-discounted prices, thanks to pharmaceutical manufacturers being required to comply with this program if they wish to participate in Medicaid. Generally, covered entities are considered safety net providers, meaning they serve a significant percentage of low income and un/under-insured patients; the 340B drug discount program helps these safety net providers financially by offsetting the high-cost administrative burden associated with providing equitable care to all patients, regardless of their ability to pay.
- Are you newly-enrolled in the 340B Program and unsure of where to go from here?
- Have you been a covered entity (CE) participating in the 340B Program for quite some time and just wanting to ensure the integrity of your program is intact?
- Are you looking to grow your already-established 340B Program to find new revenue streams and/or create expanded patient access and services?
- Are you exploring whether you would be eligible and interested in participating in the 340B Program?
If you answered YES to any of the above questions, we are here to help.
Suite of Solutions Offered:
needs assessment & gap analysis
Complete a current state comprehensive evaluation of covered entity with targeted recommendations
Feasibility and Eligibility – Do you meet eligibility criteria as defined by HRSA?
Compliance – Given the exceedingly high level of scrutiny the 340B program continues to face as well as the layers of added regulatory complexity, it is of paramount importance to ensure programmatic compliance is maintained and audited routinely. We can lend a hand to you in the following areas:
- Enrollment, registration, and recertification support
- Medicaid FFS claims billing, tracking, and reporting accuracy evaluation
- Day-to-day audit resources and tools
- Workflow
- Policy and procedure development and review
- On-site or virtual audit support
program management, oversight & optimization
The key to long-term 340B programmatic success for CEs big and small starts with proper organizational structure, oversight, and resource allocation. We can advise you on a variety of considerations that might work best for you:
- Establishment of internal advisory council or oversight committee with charter
- Infrastructure evaluation and role delineation/FTE dedication based on CE size, annual revenues, and program complexity
- Talent acquisition assistance and/or short-term operational reinforcement
- Creation/assessment of executive and employee competencies and training plans
- Benchmarking for goal-setting and establishment of KPIs
technology & systems
As a CE’s 340B Program grows in size, breadth, or complexity, it’s always a prudent idea to look to technology for help in reducing waste, improving efficiency and program compliance. We can provide support in navigating the numerous options available to you:
- Contract Pharmacy and Third Party Administrator Claims Capture Software
- Split billing software implementation and management
- Drug Inventory Management and EDI replenishment wholesaler
- Capital budget planning and development
- Vendor Request for Proposal (RFP) assistance
- Strategic planning and workflow implementation