Providing a good overview of the 340B Program, this slide presentation outlines the benefits of 340B compliance as well as the ramifications of non-compliance.
In this presentation, you’ll learn all about electronic health records (EHRs), what types of data they can store, what their benefits are and why they are needed for achieving Meaningful Use.
Looking for more info? The last slide has a list of resources for you to continue learning about EHRs.
Providing a good overview of the 340B Program, this slide presentation outlines the benefits of 340B compliance as well as the ramifications of non-compliance.
In this presentation, you’ll learn all about electronic health records (EHRs), what types of data they can store, what their benefits are and why they are needed for achieving Meaningful Use.
Looking for more info? The last slide has a list of resources for you to continue learning about EHRs.
Why is this essential? It springs from the eternal truth that the more you know your patients, the better you can respond to their current needs and predict what their future needs may be as well. The Health Care sector is now opting for Customer Relationship Management (CRM) in its daily application. CRM Health Care consists of a wide array of software products that help healthcare organizations to maintain excellent relationships with their clients. CRM enables the health care industry to get essential customer information and use it as efficiently as possible. CRM thus enables the health care sector to improve patient health, increase patient loyalty and patient retention and add new services as well. The CRM Health Care Services include strategic planning, communication services, consulting services, CRM for physicians, Campaign management, Database construction, predictive segmentation, and communications strategies.
Drug accountability: an important aspect of clinical researchTrialJoin
Drug accountability is an interesting topic related to clinical research, both for the CRAs and for the clinical research sites. Even though drug accountability isn’t a task that should be performed by the CRA, he or she is still responsible for monitoring and making sure that the site is correctly performing every task related to this field.
The topic of drug accountability is especially important in regards to quality data as well as for patient safety. For this reason, we’ll give you an in-depth explanation of everything that drug accountability entails.
An electronic health record (EHR) is a collection of patient’s electronically-stored health information in a digital and systematic format. EHR system can store data accurately.
Presentazione a cura della Dottoressa Mariangela Iodice - "L'infermiere di ricerca: ruoli e responsabilità nella Sperimentazione Clinica" - 11/04/2018 - Ospedale Sant'Eugenio - Roma
Explaining the Different Types of Routine Monitoring VisitsTrialJoin
In the clinical research industry, there are several types of basic monitoring visits that everyone involved in it should differentiate, especially CRAs (monitors). A CRA (clinical research associate) or a monitor is the person responsible for visiting a site in order to ensure that the clinical trial is being conducted properly. The CRA’s tasks include on-site visits and ensuring compliance, subjects’ safety, data quality and integrity, etc. Although clinical trials belong in the medical field, a CRA doesn’t have to be a doctor or a medical professional. It’s enough if a CRA has a background in Life Sciences, past experience in clinical trials (most often as a coordinator), and the proper training.
Care EMR's Hospital Management Information System (HMIS) software will provide a secure, robust environment for transactions across all departments of the hospital and remote access of patient medical records for physicians and nurses.
Purchasing and Inventory control in drug store
by Mrs. Anjua Parkhe and Mrs. Priyanka Kalamkar
Assistant Professor
Sraaswathi Vidya Bhavans College Of Pharmacy, Dombivli
Why is this essential? It springs from the eternal truth that the more you know your patients, the better you can respond to their current needs and predict what their future needs may be as well. The Health Care sector is now opting for Customer Relationship Management (CRM) in its daily application. CRM Health Care consists of a wide array of software products that help healthcare organizations to maintain excellent relationships with their clients. CRM enables the health care industry to get essential customer information and use it as efficiently as possible. CRM thus enables the health care sector to improve patient health, increase patient loyalty and patient retention and add new services as well. The CRM Health Care Services include strategic planning, communication services, consulting services, CRM for physicians, Campaign management, Database construction, predictive segmentation, and communications strategies.
Drug accountability: an important aspect of clinical researchTrialJoin
Drug accountability is an interesting topic related to clinical research, both for the CRAs and for the clinical research sites. Even though drug accountability isn’t a task that should be performed by the CRA, he or she is still responsible for monitoring and making sure that the site is correctly performing every task related to this field.
The topic of drug accountability is especially important in regards to quality data as well as for patient safety. For this reason, we’ll give you an in-depth explanation of everything that drug accountability entails.
An electronic health record (EHR) is a collection of patient’s electronically-stored health information in a digital and systematic format. EHR system can store data accurately.
Presentazione a cura della Dottoressa Mariangela Iodice - "L'infermiere di ricerca: ruoli e responsabilità nella Sperimentazione Clinica" - 11/04/2018 - Ospedale Sant'Eugenio - Roma
Explaining the Different Types of Routine Monitoring VisitsTrialJoin
In the clinical research industry, there are several types of basic monitoring visits that everyone involved in it should differentiate, especially CRAs (monitors). A CRA (clinical research associate) or a monitor is the person responsible for visiting a site in order to ensure that the clinical trial is being conducted properly. The CRA’s tasks include on-site visits and ensuring compliance, subjects’ safety, data quality and integrity, etc. Although clinical trials belong in the medical field, a CRA doesn’t have to be a doctor or a medical professional. It’s enough if a CRA has a background in Life Sciences, past experience in clinical trials (most often as a coordinator), and the proper training.
Care EMR's Hospital Management Information System (HMIS) software will provide a secure, robust environment for transactions across all departments of the hospital and remote access of patient medical records for physicians and nurses.
Purchasing and Inventory control in drug store
by Mrs. Anjua Parkhe and Mrs. Priyanka Kalamkar
Assistant Professor
Sraaswathi Vidya Bhavans College Of Pharmacy, Dombivli
RPh Innovations, LLC (RPHI) delivers customized pharmacy, healthcare, and 340B solutions to safety net organizations.
In this webinar, RPHI will be discussing each manufacturer block and the steps to designate contract pharmacies. We will be focused on navigating these blocks and creating a roadmap to recoup some, if not all, of the savings that were lost. We have put significant time and effort into understanding the challenges, implications, and alternative options related to the actions Manufacturers have taken over the past year. In this webinar, we share our findings, actions, and results with members.
1. Review of Manufacturer Actions
2. Steps required to designate a Contract Pharmacy
3. Challenges faced
4. Real case scenario
5. Tips and Tricks
Navigating manufacturer designations for 340 b contract pharmacies compliatricCompliatric
RPh Innovations, LLC (RPHI) delivers customized pharmacy, healthcare, and 340B solutions to safety net organizations.
In this webinar, RPHI will be discussing each manufacturer block and the steps to designate contract pharmacies. We will be focused on navigating these blocks and creating a roadmap to recoup some, if not all, of the savings that were lost. We have put significant time and effort into understanding the challenges, implications, and alternative options related to the actions Manufacturers have taken over the past year. In this webinar, we share our findings, actions, and results with members.
1. Review of Manufacturer Actions
2. Steps required to designate a Contract Pharmacy
3. Challenges faced
4. Real case scenario
5. Tips and Tricks
All participants are provided a Contract Pharmacy Designation Checklist
The 340B Program and Implications of the Mega GuidanceCompleteRx
As the 340B Drug Pricing Program continues to undergo changes, our team has been following all the recent updates and how they impact hospital pharmacies. This presentation goes through the latest on the long awaited guidance of proposed changes that was posted by the Federal Register on August 28, 2015.
Translating compliance requirements into action items 340BCompliatric
With constant changes in HRSA’s “expectations”, “recommendations” and audit focus, implementation and ongoing compliance of hospital and grantee’s 340B programs can be an arduous task, and also a moving target. RPh Innovations (RPHI), a 340B Program Support and Independent Auditor established in 2011, will re-center the focus around core statues and regulatory concepts of the program, and outline action items to help attendees start implementing structure, policy, and delegation of responsibilities within their respective institutions.
With constant changes in HRSA’s “expectations”, “recommendations” and audit focus, implementation and ongoing compliance of hospital and grantee’s 340B programs can be an arduous task, and also a moving target. RPh Innovations (RPHI), a 340B Program Support and Independent Auditor established in 2011, will re-center the focus around core statues and regulatory concepts of the program, and outline action items to help attendees start implementing structure, policy, and delegation of responsibilities within their respective institutions.
Case 13340B Drug Pricing Program OversightSection 602 of the Vet.docxketurahhazelhurst
Case 13340B Drug Pricing Program Oversight
Section 602 of the Veterans Health Care Act of 1992 was titled “Limitations on Prices of Drugs Purchased by Certain Clinics and Hospitals.”It amended the Public Health Services Act by adding a new section, Section 340B, to that act. Section 602 of the Veterans Health Care Actread in part:
Part D of title III of the Public Health Service Act is amended by adding the following subpart: “SUBPART VII – DRUG PRICINGAGREEMENTS” LIMITATION ON PRICES OF DRUGS PURHASED BY COVERED ENTITIES “Sec. 340B (a) Requirements for Agreement withSecretary – “(1) In general. The Secretary shall enter into an agreement with each manufacturer of covered drugs under which theamount required to be paid … to the manufacturer for covered drugs … does not exceed an amount equal to the average manufacturerprice for the drug under title XIX of the Social Security Act in the preceding quarter, reduced by the rebate percentage described inparagraph (2). “Rebate percentage defined. – (A) In general. For a covered outpatient drug … the ‘rebate percentage’ is the amount equalto – “(i) the average total rebate required under Section 1927(c) of the Social Security Act … for a unit of the dosage form and strengthinvolved during the preceding quarter divided by “(ii) the average manufacturer price for such a unit of the drug during such quarter….”
Section 340B applied Medicaid drug discounts to drugs purchased for clinics that served many outpatients who were not eligible forMedicaid at qualified safety-net institutions. For the most part, eligible clinics were associated with hospitals receiving disproportionateshare payments under Medicare, pediatric hospitals, and community health centers. Also included were specialized clinics and projects forHIV/AIDS, hemophilia, black lung, tuberculosis, and family planning, as well as those serving Native Americans and Native Hawaiians.Hospitals were required to be governmental or nonprofit with a contractual commitment to provide services supported by governments,have a disproportionate share percentage greater than 11.75, and not obtain the covered drugs through a group purchasing agreement. Thedrugs had to be used for patients of the covered entity and could not be resold.
A key provision of Section 340B read “(10) No prohibition on larger discount. Nothing in this subsection shall prohibit a manufacturer fromcharging a price for a drug that is lower than the maximum price that may be charged under paragraph (1).” The Patient Protection andAffordable Care Act (ACA or PPACA) increased the 340B discount to 13% on generic drugs and 23.1% on branded drugs. Specific discountshave been reported to range from 15–60% on prescription drugs. The law prohibits getting both a state Medicaid rebate and a 340Bdiscount on a drug.
BACKGROUND
In the 1980s, Congress established a discount drug purchasing program for the Veterans Administration. In 1990, it extended this discountprogram to Medicaid purchases on beh ...
SUNRx can lower the cost of drugs for patients and generate profit and cash flow for 340B eligible entities such as FQHC\'s and DSH Hospitals). We also have a Payor model which provides savings to Medicaid Managed Care organizatins. Contact me for more details!
Kalderos describes how compromised data associated with MDRP affects inaccurate Pharma Mfr payments to States leading to overpayments and compliance issues with 340B Covered Entities
Compliatric is excited to host the first of a two part 340B webinar series, presented by Ryan DiGiovanni, an Apexus Certified Expert (ACE) Pharmacist, President of EPL Health, and 340B Program Manager, Rush University Medical Center.
This webinar will provide evaluation tactics, operational considerations and planning required for covered entities before, and potentially after, participating in the 340B ESP platform. For the C-suite, this webinar will provide an overview of impact and implications of participation. For those involved in daily 340B program management, a more detailed breakdown of 340 ESP app usage, requirements, and resources will be discussed.
A healthcare business technology leader in Lighthouse Point, Florida, Travis Leonardi serves as CEO of Sentry Data Systems in nearby Deerfield Beach. One of Travis Leonardi’s areas of expertise is 340B compliance.
Under the management of the Health Resources and Services Administration, the 340B Drug Pricing Program has been helping hospitals cover the costs of essential medical care and outpatient prescription drugs for patients from low-income populations for roughly three decades. The program’s provisions extend to free vaccines and medication management services. It also funds community health programs.
The 340B Drug Pricing Program operates under the stipulations of Section 340B of the Public Health Service Act, which requires pharmaceutical manufacturers that participate in the federal Medicaid program to sell prescription drugs at discounted prices to healthcare groups that work with patients who are uninsured or otherwise in financial need. In addition to hospitals and community health centers, the 340B Drug Pricing Program works with organizations that range from hemophilia treatment centers to rural referral centers.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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2. To identify a way for State Medicaid
Agencies to recognize 340B priced claims in
order to avoid inappropriate rebate
processing
3. 340B is a Federal Discounted Drug Pricing Program that resulted
from the enactment of Public Law 102-585
1
(the Veterans Health
Care Act of 1992).
This Act came about as a means of controling the prices that
specified government agencies
2
paid for purchasing
pharmaceuticals.
The intent of this program is to expand access to affordable
medications in low income populations and help support the
operations of safety net organizations.
The 340B price is a ceiling price set by drug manufactures that is
less than the Medicaid price of an eligible outpatient drug.
4. Apexus: Responsible for negotiating prices
below the 340B ceiling price and improving
access to affordable medications through a
distribution network
5. Helps to offset the federal and state costs for
most outpatient prescription drugs dispensed to
Medicaid patients.
Requires drug manufacture’s to enter into a
national rebate agreement with the Secretary of
DHHS
4
(known as the Medicaid Drug Rebate
Agreement5
) in exchange for State Medicaid
coverage of the manufacture’s drugs.
This agreement holds manufacture’s responsible
for paying a rebate each time one of their drugs
is dispensed to a Medicaid patient
7. A 340B patient is defined as:
◦ Someone who receives healthcare services from a
covered entity that maintains health records for the
patient.
◦ Someone who is prescribed medications that are for the
treatment of a received outpatient service at a covered
entity.
◦ Someone referred for care within a covered entity (from
a non-covered entity) becomes eligible as a 340B patient
if the continuum of care is within the 340B covered entity
8. 340B covered entities are organizations
(facilities/programs) that provide medical
services to the patient and are listed in the
340B Statute as eligible to purchase drugs
through the 340B Program and appear on
the Office of Pharmacy Affairs Database.
9. Federally Qualified Health Centers (FQHC)
Comprehensive Hemophilia Treatment Centers
Ryan White Programs (Parts A, B, C, D)
8
Sexually Transmitted Disease/Tuberculosis Programs
Title X Family Planning Clinics
9
Urban / 638 Tribal Programs
10
Federally Qualified Health Center Look-Alikes (FQHC-LA)
Disproportionate Share Hospitals (DSH)
Children’s Hospitals
Free Standing Cancer Hospitals
Critical Access Hospitals
Sole Community Hospitals
Rural Referral Centers
10. Contract pharmacies work with covered
entities to fill 340B prescriptions for 340B
eligible patients. The covered entity is
responsible for maintaining health records
for the patient and the pharmacy is
responsible for maintaining medication
records for the patient with access to the
patients health records.
11. 1. Hospital: The hospital must be eligible for 340B and registered with the 340B
program.
2. Patient: Patient must be seen in an outpatient facility or service area which
is “integral” to the hospital (i.e., whose costs are listed on the reimbursable
section of the hospital’s latest Medicare Cost Report-records each institution's
total costs and charges associated with providing services to all patients).
3. Provider: Patient must be seen by a provider who is employed
by, contracted by, or through other arrangements (such as a referral for
consultation). “Other arrangements” are applicable if the prescriptions captured
are “proximate in type and time” to the care patients receive at the hospital.
4. Records of Care: The record of care and responsibility of care must reside
with the hospital
5. Pharmacy: Patient must obtain their prescription at the hospital’s pharmacy
or from one of its 340B contracted pharmacies.
12. Ship-to Bill-to Method: With contract
pharmacies, the 340B drugs get billed to the
covered entity and shipped to the pharmacy
address
Virtual inventories: It is managed by software
from a third party company (Ex. SunRx). It
limits the risk of diversion because it accounts
for every 340B script that is filled.
Replenishment Systems: Easier to maintain
when using a virtual inventory because the
third party automatically replenishes the
pharmacy’s stock without the actual pharmacy
needing to keep track of used medications
14. 1. Use 2 McKesson accounts, use parenthesis around drug
name to identify 340B
2. Use dual inventory system, created NRX13
system, use
asterisk around product name to identify 340B, use ship-to
bill-to
3. Use electronic inventory, uses patients to identify
4. Wrong contact person
5. Uses CaptureRx
15. 6. Referred to another person in charge of CHAMP14
program
7. Doesn't participate, 340B is to confusing
8. Clinic does everything and replaces drugs used in
pharmacy
9. (had a 340B contact person listed that was in charge of
multiple sites) Doesn’t participate in MD
10. Two separate inventories and 2 separate accounts with
wholesaler
16. 11. One store participates, uses 3rd party to identify
340B scripts (would not disclose name of 3rd party)
12. Told me to address any questions to the covered
entity, doesn’t know much about 340B
13. Four 340B hospitals out of 10
14. Mixed-use = carve in, retail = carve out, uses
replenishment model, uses virtual inventory system to
track usage (does not identify drugs at shelf level)
15. Use ship-to bill-to, doesn’t use any inventory system
17. 16. One program in MD, virtual inventory
system, retail pharmacy contract, bill-to
ship-to replacement method
* Results: HRSA website contained
inconsistencies with contact name, contact
number, and participating information
18. Use Provider NPI
15
Use HRSA Exclusion File: contact providers
to ensure participation
Use an agency created exclusion file and
audit that against HRSA exclusion file
Use NCPDP
16
Transaction Strings: basis of
cost and 340B indicator fields
19. Monthly Claims Audit is required from 340B
pharmacies: monitors that discount is being
passed on to Medicaid
340B providers have different ID numbers
Dual inventory systems
Avoiding Duplicate Discounts:
◦ Exclude all claims from entities on HRSA
exclusion file in rebate processing, encourage
providers to be all in or all out.
20. Charge no more than actual acquisition cost
+ dispensing fee
Use Usual and Customary pricing: to
identify 340B claims on invoices
Pay dispensing fees up to $12.00
*data was obtained from 42 states*17
21. The 340B ceiling prices are calculated according to a formula
that is based on information generated in connection with the
Medicaid drug rebate program
Manufacturers are required to report to the Centers for
Medicare & Medicaid Services (CMS) each quarter the average
manufacturer price (AMP) for each of their drugs
CMS uses AMP and other data to calculate a unit rebate
amount (URA) that serves as a basis for the rebate amounts
paid by manufacturers
The AMP and URA used in the 340B ceiling price formula are
based on the smallest dispensable unit of each drug
The 340B ceiling price is based on these components and is
essentially equal to the AMP reduced by the URA
22. The 340B ceiling prices per package are
calculated as follows:
◦ [(AMP) - (URA)] * drug’s package size
23. Can’t identify by pharmacy: purchase 340B and
non 340B drugs
Can’t identify by patient: they bring in the
prescription (unless entity fills all 340B scripts)
Can’t identify by prescriber: may work at 340B
and non 340B entity
Can’t identify by NDC
19
: 340B and non 340B
dugs have same NDC (some places put a
unique identifier in the NDC)
24. Have provider differentiate 340B claims at time
of submission
Split billing software to differentiate 340B claims
Implementing audit forms
*after verifying all information is accurate* -
Require all participating entities on the HRSA
exclusion file to purchase and bill all Medicaid
drugs under 340B pricing
25. Include a line in the NCPDP transaction that
codifies a 340B claim
Recommend that state Medicaid Agencies
come together and petition for HRSA to
release 340B prices
26.
27. 1.Limitation on prices of drugs
2. US Department of Veterans Affairs: (Big 4) Department of Veterans Affairs, the
Department of Defense, Public Health Service/Indian Health Service, and the Coast
Guard. These government agencies receive special pricing discounts on pharmaceuticals
in accordance with public law 102-585.
3. Partnership between CMS, State Agencies, and participating drug manufactures
4. Department of Health and Human Services
5. Medicaid Drug Rebate Agreement: http://www.medicaid.gov/Medicaid-CHIP-Program-
Information/By-Topics/Benefits/Prescription-
Drugs/Downloads/ManufacturerContactForm.pdf
6. Health Resources and Services Administration
7. Office of Pharmacy Affairs
8. Ryan White Programs: http://www.hab.hrsa.gov/abouthab/aboutprogram.html
9. Title X Family Planning Clinic:
http://www.hrsa.gov/opa/eligibilityandregistration/specialtyclinics/familyplanning/index.
html
10. Urban/Tribal Programs:
http://www.hrsa.gov/opa/eligibilityandregistration/healthcenters/tribalurbanindian/inde
x.html
11. SunRx:
http://www.ihaonline.org/imis15/Images/IHAWebPageDocs/upcomingevent/handouts/a
m/wednesday/W3%20-
%20Improving%20Pharmaceutical%20Access,%20Understanding%20the%20340B%20
Program%20-%20David%20Hardman.pdf
28. 12. Health Resources and Services Administration
13. Electronic system created to manage 340B inventory
14. Maryland Child Abuse Providers at the University of Maryland
Children’s Hospital (Part of the University of Maryland Medical Center)
15. National Provider Identifier
16. National Council for Prescription Drug Programs
17. Nebraska, Ohio, New York, Minnesota, Washington, Alaska, Alabama,
Arizona, Arkansas, California, Connecticut, Delaware, Iowa, Louisiana,
Maine, Massachusetts, Mississippi, Montana, Illinois, Nevada, Oklahoma,
Missouri, New Hampshire, New Mexico, Oregon, Rhode Island, New
Jersey, South Carolina, South Dakota, North Dakota, Tennessee, Texas,
Utah, Colorado, Florida, Georgia, Michigan, Kentucky, Wisconsin, West
Virginia, Virginia, Pennsylvania
18. Office of the Inspector General, 2006
19. National Drug Code
29. Apexus 340B University. (2013, April). 340B Glossary of Terms. Retrieved
April 26, 2013, from
https://docs.340bpvp.com/documents/public/resourcecenter/glossary.pdf
Public Law 102-585. (2012, October 12). In United States Department of
Veterans Affairs. Retrieved April 26, 2013, from
http://www.fss.va.gov/faqs/publicLaw102585.asp
Review of 340B Prices. (2006, July). In Office of the Inspector General.
Retrieved May 3, 2013, from http://oig.hhs.gov/oei/reports/oei-05-02-
00073.pdf
HRSA FAQ :http://www.hrsa.gov/opa/faqs/
340B Drug Pricing Program: http://www.hrsa.gov/opa/
340B Prime Vendor Program: https://www.340bpvp.com/controller.html
30. Office of Pharmacy Affairs (OPA)
Phone: 301-594-4353
Mailing Address: Office of Pharmacy Affairs, HRSA
5600 Fishers Lane
Parklawn Bldg, Room 10C-03
Rockville, Maryland 20857
Pharmacy Support Services Center: 1-800-628- 6297
Editor's Notes
340B Prime Vendor Program: http://www.hhs.gov/opa/pdfs/340b-prime-vendor-programs-slides.pdf