According to the report, overly-broad eligibility criteria for hospitals have led to an explosion in the number of hospitals that have come into the 340B program. competition for community-based practices...For oncology practices, one reason cited for the growth is the opportunity to expand the patient base for drugs purchased under the 340B discount drug purchase plan.
Some of these problems originate from the fact that current 340B guidance does not require cost savings to be passed on to needy “qualified patients.” 119, 128 (2010).GAO, Standards for Internal Control in the Federal Government, GAO-AIMD-00-21.3.1 (Washington, D.C.: Nov. 1999)Public Health Service Act § 340B, 42 U.S.C. However, 340B stakeholders reported issues with covered entities accessing intravenous immune globulin (IVIG) at 340B prices.GAO said that HRSA's oversight of the 340B program is inadequate to provide reasonable assurance that covered entities and drug manufacturers are in compliance with program requirements—such as, entities' transfer of drugs purchased at 340B prices only to eligible patients, and manufacturers' sale of drugs to covered entities at or below the 340B price. Failure to recertify will result in removal from the 340B program.Two specific criteria are common to most of the 340B-eligible hospital types: the requirement for a "disproportionate share hospital (DSH) adjustment percentage" above a certain level;The DSH adjustment percentage determines whether hospitals receive higher cash payments from the federal government under Medicare’s Inpatient Prospective Payment System.In 2003, Congress enacted a law that allowed more rural and small urban hospitals to become eligible for the program by meeting the DSH percentage threshold required for program enrollment.There have been a number of government reports relating to the 340B program. A drug manufacturer enters into a Pharma-ceutical Pricing Agreement (PPA) with Health Resources & Services Administration (HRSA). Analysis on the underemployment number in the monthly jobs report. All COVID-19 information related to the 340B Program will appear on the COVID-19 Resources page, and we will update resources as they become available.
The TPA uses this information to scan the data from the ‘Switch’ and from that determine where the CE’s patients are going to fill prescriptions. 2006) at 1 [hereafter referred to as OIG 2006 340B Report].OIG, Pharmaceutical Manufacturers Overcharged 340B-Covered Entities, OIG (Washington, D.C.: March 2003).B. The hospitals are keeping the difference." § 1296r-8(a)(5)(B)).Patient Protection and Affordable Care Act, Pub. The 340B program specifically was modified in four major ways by the legislation. 340B CEs may provide their services in a variety of settings such as hospitals, clinics, even off-site pharmacies. Though the statute was written with the intent to lower the cost of Medicaid care, it contained no exception in the ‘best price’ calculation for charitable giving. Because the [Outpatient Prospective Payment System] payment rates for drugs furnished to hospital outpatients are the same for all hospitals without regard to whether the drugs were purchased through the 340B program, hospitals have an incentive to increase margins by expanding their patient base for chemotherapy administration. "FQHCs rely on the 340B funding to offset the costs of providing these and other important (yet unreimbursed) services. And while the 340B program lowers outpatient drug costs for qualifying hospitals on the presumption that it will help significant numbers of vulnerable, uninsured patients, participating hospitals currently see no restrictions on the way they spend the revenue generated if they charge both insured and uninsured patients higher prices than the 340B-discounted price. from Georgetown University where she focused her studies on health care policy, and is licensed in New Jersey.Introduction
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how does 340b work