340 B Program Overview Agenda What is 340

340 B Program Overview

Agenda ● ● ● ● What is 340 B? 340 B Health Video Overview and History Who is Served 340 B Need to Know Drug Distribution and Requirements Benefit of the 340 B Program How organizations use 340 B Revenue

What is 340 B? The 340 B Drug Pricing Program requires drug manufacturers to provide outpatient drugs to eligible health care organizations/covered entities at significantly reduced prices. Participants can pass the savings along to patients or can use the savings to provide more services in their communities. The 340 B Program enables covered entities to stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services. Source: Health Resources and Services Administration (HRSA) Office of Pharmacy Affairs (OPA); the government agency that oversees the 340 B program.

340 B History Government program signed into law in 1992 by George H. W. Bush Helps safety net health care organizations (known as “covered entities”) stretch scarce federal resources in order to provide service to more patients Requires pharmaceutical companies to sell medications to covered entities at a reduced rate Administered by the Office of Pharmacy Affairs (OPA), which is part of Health Resources and Services Administration (HRSA) The 340 B Program in One Sentence

Overview 340 B Drug Pricing Program

340 B Need to Know Covered Entity: A facility/program that is listed in the 340 B statute as eligible to purchase drugs through the 340 B Program and appears on 340 B OPAIS. 340 B-Eligible Patient: Covered entity has an established relationship with the patient. The patient receives health care from a healthcare professional employed by or under contract by the covered entity. An individual will not be considered a patient of the covered entity if the only health care service received by the individual from the covered entity is the dispensing of a drug or drugs for subsequent self-administration or administration in the home setting.

How organizations use 340 B revenue ● ● ● Support uninsured patients Expand service offerings Mobile clinics Hire more staff Open new clinic locations Keep facilities open Report Details How Hospitals Spend 340 B Drug Savings

340 B Need to Know ● Duplicate Discount -when a covered entity obtains a 340 B discount on a medication and a Medicaid agency obtains a discount in the form of a rebate from the manufacturer for the same medication. ○ Covered Entities must choose to Carve In or Carve Out for Medicaid MCO Patients Carve In = we use 340 B for Medicaid MCO patients ● Carve Out = we don’t use 340 B for Medicaid MCO patients Diversion - giving the 340 B discounted price to an ineligible patient. Our 340 B team is responsible for ensuring this doesn’t happen.

Contract Pharmacies ● 340 B Savings are generated only when patients fill at our 340 B Contract Pharmacies ● (Insert your health center’s list of contract pharmacies. )

Who is Served - Types of Covered Entities Health Centers ● ● Federally Qualified Health Centers Federally Qualified Health Center Look. Alikes Native Hawaiian Health Centers Tribal/Urban Indian Health Centers Hospitals ● ● ● Children's Hospitals Critical Access Hospitals Disproportionate Share Hospitals Free Standing Cancer Hospitals Rural Referral Centers Sole community Hospitals Ryan White HIV/AIDS Program Grantees ● Ryan White HIV/AIDS Program Grantees Specialized Clinics ● ● ● Black Lung Clinics Comprehensive Hemophilia Diagnostic Treatment Centers Title X Family Planning Clinics Sexually Transmitted Disease Clinics Tuberculosis Clinics

340 B Drug Distribution and Requirements ● ● ● Patient must have been seen at a 340 Beligible site Prescription at the Pharmacy Generally brand name drugs Insurance cannot be Medicaid (avoid duplicate discounts) Pharmacy must be in a contract with Pharmacy Benefit Manager that pays for the medication Drug must be available from wholesaler at 340 B price

What is the benefit of 340 B? ● Covered Entities can purchase medication at a below market rate and; ○ Sell those medications at lower rate to their uninsured patients; AND ○ Sell those medications at market rate to their insured patients taking advantage of this increased “spread” to help fund their mission. ■ The key is that these medications must be dispensed through a pharmacy that has a contract with the covered entity.

How organizations use 340 B revenue ● Support uninsured patients ● Expand service offerings ● Mobile clinics ● Hire more staff ● Open new clinic locations ● Keep facilities open Report Details How Hospitals Spend 340 B Drug Savings

How our organization uses 340 B revenue

How to support our 340 B program ● Be aware that we have it! ● Check out our 340 B Contract Pharmacies list. We offer: ● ○ Home delivery ○ In-house pharmacy ○ Retail options We don’t tell patients where to fill, but if they ask for a recommendation, we have plenty of good options within our 340 B program!