Thought Leadership
When it comes to thought leadership and staying informed, we’ve got you covered. See below for recent articles, webinars, and downloadable resources available.
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HRSA has indicated it will allow a hospital to accelerate timelines for its offsite locations to begin participating in the 340B Drug Discount Program. Previously, offsite locations were required to be reimbursable on a hospital’s most recently filed Medicare cost report and then registered with HRSA before patients seen at the offsite location could be […]
The White House Office of Management and Budget (OMB) approved the Centers for Medicare & Medicaid Services’ (CMS) plan, proposed September 30, 2019, to survey 340B hospitals for their net costs for 340B-purchased drugs billed to Medicare Part B, including sub-340B ceiling price discounts and 340B penny prices. CMS announced the final survey requirement on […]
This article was originally published on March 25th and was updated on April 23rd. It is being updated as new information becomes available. We wanted to provide updates on the most recent HRSA announcements that could impact your 340B Program during the COVID-19 crisis. 340B Eligibility HRSA recently announced that it “is allowing some entities, […]
We wanted to share an urgent update on the impending billing changes that were scheduled to take effect on 4/1/2020. In a communication we acquired today from Jessin Joseph, Pharmacy Director with KY Department of Medicaid Services, it was announced the Department has made the decision to delay the implementation of the required 340B modifiers […]
Consolidated Health Center & FQHC Look-a-Likes The 2020 Grantee recertification period for Consolidated Health Centers, Federal Qualified Health Center Look-Alikes, Ryan White, Comprehensive Hemophilia Treatment Centers, Native Hawaiian, Black Lung Programs, Urban Indian, and Tribal Compact 638 will be January 27-February 24, 2020. Mandatory Requirement Health clinics must complete their recertifications through the Office of […]
The Health Resources and Services Administration (HRSA) has set the annual recertification of eligibility for 340B drug discounts for hospitals to begin August 19, 2019, and end September 16, 2019. Mandatory Requirement The Authorizing Official (AO) and Primary Contact (PC) must request a User ID and Password prior to the start of the registration process. […]
Attention 340B covered entities participating with Anthem Blue Cross and Blue Shield: Effective April 1, 2019, Anthem requires that a “JG,” “TB,” or another relevant modifier be added to claims involving 340B eligible outpatient drugs under the Medicare Outpatient Prospective Payment System (OPPS). This decision by Anthem resembles the January 1, 2018 decision by the […]
Attention 340B covered entities participating with Humana – Managed Care Medicare: Effective January 1, 2019, Humana requires that a “JG,” “TB,” or another relevant modifier be added to claims involving 340B eligible outpatient drugs under the Medicare Outpatient Prospective Payment System (OPPS) with status indicator “K.” If a claim does not include the proper modifier […]
On December 28, 2018, a federal judge in Washington reversed the enormous cuts to Medicare OP Drug payments implemented by CMS which were effective January 1, 2018. U.S. District Judge Rudolph Contreras ruled CMS and HHS secretary exceeded their authority by cutting 340B reimbursement by approximately 28.5%. The Medicare OP Drug reimbursement methodology for certain hospitals […]
Compliance is often a misunderstood word that most healthcare professionals associate with spending more time and money. Typically, compliance is defined as a certification or confirmation that the doer of an action or manufacturer of a product meets the requirements of accepted practices, legislation, prescribed regulations, specified standard or terms of a contract. 340B Program […]
The Health Resources and Services Administration has set the annual recertification of eligibility for 340B drug discounts for hospitals to begin August 15, 2018, and ends September 12, 2018. Mandatory Requirement Hospitals must complete their recertification through the Office of Pharmacy Affairs Information System (OPAIS). The Authorizing Official and Primary Contact must create their own […]
Many covered entities were recently notified that CVS had acquired 340B software vendor Wellpartner, Inc. As the 340B Program has evolved over the last several years, it is common for pharmacy retail chains to develop preferred relationships with 340B software vendors. CVS has indicated that they will transition individual retail locations to Wellpartner throughout 2018, […]
In the past, HRSA utilized its own staff to perform 340B audits. Beginning late last year, HRSA contracted with the Bizzell Group to conduct audits on its behalf. The Bizzell Group staff members have more pharmacy experience than their HRSA predecessors. Many of them have worked in hospitals that participate in the 340B program. HRSA […]
Webinars
Great news for 340B hospitals impacted by the reimbursement reductions initiated by the Center for Medicare and Medicaid Services (CMS) on January 1, 2018. Recently, CMS announced that the 2023 Medicare outpatient payment rates will be restored to rates prior to 2018 for affected hospitals. After many legal debates, court filings, and outcry from hospitals […]
In June, the Supreme Court gave hospitals participating in the 340B Drug Pricing Program a convincing victory ruling unanimously that the U.S. Center for Medicare & Medicaid Services (CMS) should not have reduced reimbursement for covered outpatient prescription drugs purchased by those hospitals. 340B Hospitals Challenge Payment Rates Hospitals challenged the 2018 and 2019 payment […]
Great news for 340B Hospitals affected by COVID-19. On March 15, 2022, President Biden signed into law the $1.5 trillion Consolidated Appropriations Acts, 2022. This bill allows Hospitals that have lost eligibility due to a decrease in their Medicare disproportionate share (DSH) percentage as a result of the COVID-19 public health emergency to regain access […]
The 340B Program has seen a lot of changes in 2021. Join Blue & Co.’s Apexus Advanced 340B Experts for a webinar on Thursday, July 15 at 12:00 p.m. In this webinar, Jason Prokopik and Chad Downing will be covering some of the current 340B trends and provide updates from recent HRSA Audits that may […]
After months of pharmaceutical manufacturers placing restrictions on the 340B Program to both contract pharmacies and covered entities, HRSA sent letters to six pharmaceutical manufacturers stating they violated the 340B Statute. The HRSA Acting Administrator declared these pharmaceutical manufacturers violated the 340B statue by placing restrictions on the 340B Program pricing at both contract pharmacy […]
Over the past year, there have been many changes within the 340B Program. Join Jason Prokopik from Blue & Co., LLC and Wes Butler from Barnett Benvenuti & Butler on Tuesday, February 9 from noon to 1 p.m. EST as they discuss how the recent political changes could impact the 340B Program and what it […]