The Arkansas Insurance Department (AID) has formally notified at least four drugmakers that they are in potential violation of a [...] …
Month: August 2023
Congress is unlikely to clear any major reform of the 340B in the remaining months of 2023, unless spurred by [...] …
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As the complexity of managing 340B programs continues to increase, there is a growing need for advanced tools and technologies to ensure compliance integrity and optimize financial stewardship. In this article, we’ll explore the scope of analytics and artificial intelligence (AI) in enhancing 340B programs. By leveraging AI capabilities, such as active decision-making and passive information generation, covered entities can unlock the potential for improved efficiency, accuracy, and cost savings.
Scope of Analytics & AI in 340B
Analytics and AI technologies offer significant opportunities to augment 340B programs and drive better outcomes. Active AI enables the automation of real-time decisions and actions within 340B software, based on pre-defined parameters set by a 340B program expert. While real people are still essential to your 340B program, active AI can be used to make the efforts of your 340B team more effective and efficient.
On the other hand, passive information AI
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The Health Resources and Services Administration (HRSA) has awarded a $25.3 million, five-year contract to The Bizzell Group to audit [...] …
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Drug maker Boehringer Ingelheim (BI) sued the federal government to block Medicare price negotiations shortly before the Department of Health [...] …
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TIP: Make sure you keep an eye on your prescriber lists.
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Recent apparent changes to 340B drug pricing conditions by drug manufacturer Sanofi may eliminate 340B discounts for health centers using [...] …
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The congressional sponsor of legislation that would require hospitals and potentially other covered entities to publicly report their 340B revenue, [...] …
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When a covered entity enrolls in the 340B program it must inform the Health Resources and Services Administration (HRSA) whether it will “carve in” and acquire 340B drugs for its Medicaid fee-for-service (FFS) eligible patients, or “carve out” and purchase drugs for its FFS patients outside the 340B program.
A covered entity choosing to carve in Medicaid FFS claims must provide the HRSA Office of Pharmacy Affairs (OPA) with the Medicaid Provider Number(s) (MPNs) or National Provider Identifier(s) (NPIs) it uses to bill FFS Medicaid (in any state) for 340B drugs. This information will appear on the 340B Medicaid Exclusion File (MEF), notifying states and manufacturers that drugs purchased under that MPN or NPI are not eligible for a Medicaid rebate. Covered entities are required to ensure that the information listed on the MEF is accurate.
Published quarterly on the OPA Information System (OPAIS), the MEF is the data source HRSA uses to assist
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A federal district judge has allowed five major drugmakers to file friend-of-the-court briefs in a lawsuit over patient eligibility to [...] …