What is 340B?
- The 340B Drug Pricing Program requires drug manufacturers to provide outpatient drugs to eligible healthcare organizations at significantly reduced prices.
What are the objectives of this program?
- Stretch scare federal healthcare financial resources by providing pricing benefits and additional revenue stream to eligible entities. The resulting savings and revenues are intended to be used to provide more care to vulnerable populations.
- Increase patient compliance leading to better patient outcomes.
How to participate in the 340B program
- Qualified Entity registers with HRSA to become CE
- CE contracts with qualified pharmacy to fill scripts for qualified patients
- Scripts are submitted to Contract Pharmacy for qualified patients and drugs are dispensed
- Contract Pharmacy adjudicates claims with MCO’s, collects payments, takes management fee, remits payments to suppliers and distributes balance to CE
- Children’s Hospitals
- Disproportionate Share Hospitals
- Ryan White Grantees
- Title X Family Planning Clinics
- STD Clinics
- Individual must receive health related services other than drugs from the covered entity.
- Entity has an established relationship with the patient
- Individual receives healthcare services from a healthcare professional who is either employed by the covered entity or other arrangements (case management or referral) such that the responsibility for the care provided remains with the covered entity.
- Individual receives a healthcare service or range of services from the covered entity which is consistent with the service or range of services for which grant funding or Federally-qualified health center look alike status has been provided to the entity.
EXCEPTION: An individual registered in a state operated or funded AIDS drug purchasing assistance program receiving financial assistance under title XXVI of the PHS Act will be considered a patient of the covered entity for purposes of this definition if so registered by the State program
An individual will not be considered as an eligible patient of the covered entity if the only healthcare service the individual receives from the entity is the dispensing of drugs.