Expert Tips

TIP: When it comes to duplicate discount prevention, don’t assume that all 340B drugs are billed to Medicaid using the same NPI. Routine internal auditing of Medicaid claims and proactive communication with finance/billing can help identify additional NPI numbers that may need to be listed on HRSA’s Medicaid exclusion file.

TIP: The key to unlocking the full potential of your program starts with complete understanding of your data.

TIP: If your entity engages a firm to independently audit your 340B Program, follow through on the auditor’s recommendations in a timely manner.

TIP: Don’t forget that in a replenishment model, 340B purchases are primarily made after determining eligibility through accumulated eligibility.

TIP: Make sure you are taking time to review your 340B wholesaler invoices at least weekly to ensure you are getting the correct 340B price.

TIP: When using outsourced telehealth services, be prepared to “Mind the Gap.”

TIP: When approving your 340B wholesaler invoices for payment, make sure to compare the invoiced amount to your 340B catalog or the ceiling price to ensure you were not overcharged.

TIP: For any covered entities with a contract pharmacy program, it is critical to review carve-out/ineligible claims data from your TPA system(s) to understand why claims are not qualifying in your 340B program.

TIP: For sites submitting data to 340B ESP, the option exists within the 340B ESP portal to “Attest” for several manufacturers which will help to enable 340B pricing in advance of receiving any claims for these manufacturers.

TIP: Accurately tracking and loading drug prices into the ESP system can be the difference maker when it comes to maintaining compliance and ensuring maximum savings.