Claim Capture by Provider Type: A Compliance and Maximization Guide

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Understanding Provider Panels

Provider panels are lists used by 340B Third-Party Administrators (TPAs) to determine which providers’ claims are 340B eligible.  At a minimum, a provider panel should include:

  • Provider’s eligible
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Providers Raise Caution on Claims Data Submission Requirements After 340B ESP Terms of Use Update Continues to Defer to Manufacturers

Second Sight Solutions updated 340B ESP's terms of use on Oct. 4.
Editor’s Note: An earlier version of this story incorrectly suggested that an Oct. 4 update to 340B ESP’s terms of [...]

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Health Centers Urge Federal Appeals Court to Take Their Side in Case Alleging Drug Manufacturer Collusion on Contract Pharmacy Restrictions

Two community health centers argued in a Sept. 30 filing with the U.S. 2nd Circuit Court of Appeals that diabetes drugmakers colluded to place contract pharmacy restrictions.
Two community health centers urged a federal appeals court to overturn the dismissal of their 340B antitrust lawsuit, arguing in [...]

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CMS Inaction on IRA-340B Conflicts May Drive ‘Manufacturer-Friendly’ Compliance Models

340B-IRA interactions
CMS has not assumed responsibility for “deduplicating” discounts that arise between the 340B program and the IRA's Medicare drug price negotiations.
Federal regulators’ inaction on the 340B program’s interactions with Medicare drug price negotiations will likely lead drugmakers to pursue “manufacturer-friendly” [...]

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FQHCs Reinvest 340B Savings in Safety-Net Care, JAMA Study Finds

Federally qualified health centers (FQHCs) appear to use their 340B program savings to enhance safety-net care, according to a new study in JAMA Health Forum.
Federally qualified health centers (FQHCs) appear to use their 340B program savings to enhance safety-net care, according to a new [...]

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State Contract Pharmacy Lawsuit Weekly Roundup: Orders and Filings in Arkansas, Louisiana, Kansas, Mississippi Maryland, Missouri

Key motions were filed this week in state contract pharmacy litigation in Arkansas, Maryland, Louisiana, Kansas, Missouri, Minnesota and Mississippi.
Editor’s Note: With 340B-related litigation heating up in several states following the enactment of new contract pharmacy access laws, 340B [...]

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Head of Drug Industry-Funded Think Tank Backs J&J’s Proposed Rebate Model, Slams Hospitals in Op-Ed

Sally Pipes, the president and CEO of the drug-industry funded Pacific Research Institute, criticized pushback that led Johnson & Johnson to forgo its plans to implement a 340B rebate model in an Oct. 7 Forbes op-ed.
The leader of a right-leaning think tank that’s received funding from the drug industry criticized pushback that led Johnson & [...]

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340B PROVIDER LEADER SPOTLIGHT

Edline Victor, Director of Pharmacy, Whole Family Health Center and 2024 Scholarship Recipient for the Apexus Advanced 340B Operations Certificate Program

Edline Victor

Q: Where did you go to college/graduate school?

I completed a bachelor’s in biomedical sciences with a minor in public health from the University of South Florida

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Expert Tip from Maxor

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TIP: Covered entities must protect their 340B programs from manufacturers attempting to reduce savings and eligibility.


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CMS’ MDRP Final Rule May Impact 340B Covered Drugs, Attorneys Say

CMS' recently-released MDRP final rule may affect 340B covered drugs and draw litigation.
A new federal regulation updating the definition of a covered outpatient drug could change the number of drugs covered under [...]

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