Are you offering special 340B
drug pricing to your patients?

No, let DataRx help!
 

What is the 340B Drug Program?

Section 340B of the Public Health Service Act was enacted in 1992.  It requires manufacturers to provide outpatient drugs to eligible providers at a reduced price.  The 340B price establishes the highest price the covered entity would have to pay for select outpatient and over-the-counter drugs and also minimum savings the manufacturer must provide. The 340B price is at least as low as the price that state Medicaid agencies currently pay.

The savings achieved through 340B pricing may range between 25-50% off covered outpatient drugs.  Eligible providers must determine how it will order and receive the low-priced drugs.  They can do so by either contacting drug manufacturers directly or working with a wholesaler.

What Organizations are Eligible for 340B Discounts?

• Federally-qualified health center (as defined in section 1905(l)(2)(B) of the Social Security Act). This category includes:
• FQHC Look-alikes
• Consolidated Health Centers (Sec.330(e) Public Health Service Act)
• Migrant Health Centers (Sec.330 (g) Public Health Service Act)
• Health Care for the Homeless (Sec.330(h) Public Health Service Act)
• Healthy Schools/Healthy Communities
• Health Centers for Residents of Public Housing (Sec. 330(i) Public Health Service Act)
• Office of Tribal Programs or urban Indian organizations (P.L. 93-638 and 25 USCS §1651)
• A family planning project receiving a grant or contract under Sec. 1001 PHSA (42 USCS§3001)
• An entity receiving a grant under subpart II of part C of Title XXVI of the Ryan White Care Act (RWCA) (relating to categorical grants for outpatient early intervention services for HIV disease) - Early HIV Intervention Services Categorical Grants (Title III of the RWCA)
• A State-operated AIDS Drug Assistance Program (ADAP) receiving financial assistance under the RWCA
• A black lung clinic receiving funds under Section 427(a) of the Black Lung Benefits Act (30 USCS§901)
• A comprehensive hemophilia diagnostic treatment center receiving a grant under section 501(a)(2) of the SSA
• A Native Hawaiian Health Center receiving funds under the Native Hawaiian Health Care Act of 1988 (42 USCS§11701)
• An urban Indian organization receiving funds under title V of the Indian Health Care Improvement Act (25 USCS§1601)
• Any entity receiving assistance under title XXVI of the Social Security Act (other than a State or unit of local government or an entity described in subparagraph (D)), but only if the entity is certified by the Secretary
• An entity receiving funds under section 318 (42 USCS §247c) (relating to treatment of sexually transmitted diseases) or section 317(j)(2) (42 USCS§247b(j)(2)) (relating to treatment of tuberculosis) through a State or unit of local government, but only if the entity is certified by the Secretary
• A disproportionate share hospital (as defined in section 1886(d)(1)(B)) of the SSA - (i) is owned or operated by a unit of State or local government, is a public or private non-profit corporation which is formally granted governmental powers by a unit of State or local government, or is a private non-profit hospital which has a contract with a State or local government to provide health care services to low income individuals who are not entitled to benefits under title XVIII of the Social Security Act or eligible for assistance under the State plan under this title; (ii) for the most recent cost reporting period that ended before the calendar quarter involved had a disproportionate share adjustment percentage (as determined under section 1886(d)(5)(F) of the Social Security Act) greater than 11.75 percent or was described in section 1886(d)(5)(F)(i)(II) of such Act; and (iii) does not obtain covered outpatient drugs through a group purchasing organization or other group purchasing arrangement.

What Patients are Eligible for 340B Drug Pricing?

Any patient of a participating 340B entity is considered a 340B patient provided the entity maintains control of the patient's medical records and has the primary responsibility for the patient's care.  For more information, refer to the U.S. Department of Health and Human Services, Health Resources and Services Administration – Pharmacy Services Support Center web site at http://pssc.aphanet.org/default.htm

What Drugs are Covered?

Section 340B requires manufacturers to sell any drug provided in an outpatient setting to eligible entities at or below the established 340B ceiling price. This includes prescription drugs and can include over-the-counter drugs, if a prescriber writes a prescription for the drug. Vaccines and drugs given to the patient in inpatient care settings are excluded from the 340B Drug Pricing Program.

How can DataRx Help?

DataRx will work closely with clients to manage and audit the process and ensure compliance with Federal guidelines.

Program Management

• Provides Multiple Plan Options
• Customized to Meet Customer’s needs
• Maintains your 340B Formulary
• Customizable to Meet Customer’s needs
• Issues Monthly Reports
• Tracks Patients Throughout the System
• Manages Wholesaler Relationships
• Manages Price Discrepancy Issues
• Offers this Services at an Industry Low Administration Fee

Inventory Control and ordering system

• Maintain Virtual Inventory of all 340B Drugs at Pharmacy
• Generate Drug order and transmit to Wholesaler
• Automatic Reordering is Available
• Record drug purchases
• Compare prices charged to 340B prices
• Approve payment of invoices
• Forward payment information to client finance department

Claim Processing

• Manage and Maintain Plan Designs
• Adjudicate Claims from Contracted Pharmacies
• Provide real time Drug Utilization Review (DUR).
• Provide Pharmacy Helpdesk Services

Monthly Financial Reconciliation

• Complete Reconciliation of 340B drugs and Retail drugs
• Provide monthly financial reports

Sliding Scale Fee Program and Eligibility Management

• Provides Real-Time Eligibility Management
• Manages and Maintains 340B Discount Program
• Develop and Distribute Prescription Cards