Q: Where did you go to college/graduate school?
I graduated Pharmacy school from Oregon State University in 1999. I first graduated with a BS in Chemistry from Southern Oregon
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Do you think you know Powers Law? You may know that Powers has represented 340B safety net hospitals, Ryan White clinics, community health centers as well as state and local governments and retail pharmacies since the 340B program’s inception in 1992. You may also know that Powers has a strong reputation for compliance work, 340B-related litigation, and building coalitions to advocate effectively for the 340B program. What you don’t know about us may surprise you.
Bill von Oehsen, JD
- Bill played a key role in helping to enact the 340B program in 1992, as well as to expand the law in 2010 under the Affordable Care Act to include additional safety net hospitals as covered entities and to establish numerous program integrity requirements.
- Bill helped to establish 340B Health, an advocacy organization of more than 1,400 public and private nonprofit hospitals participating in the 340B program. He also helped organize the 340B Coalition, an organization of a dozen national associations
Q: Where did you grow up?
Houston, TX
Q: Where did you go to college?
Texas A&M University (College Station, TX)
Q: What are your favorites?
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Confucius once said that “roads were made for journeys, not destinations.” Hudson Headwaters has been at the forefront of the 340B journey for 20 years while continuously leveraging field-driven experience to help clients effectively navigate and manage their 340B involvement. Our goal is to prevent the 340B program model from reaching an unexpected destination.
Hudson Headwaters 340B, LLC (a wholly owned subsidiary of Hudson Headwaters Health Network) has pioneered a natural path to compliant management of multiple contract pharmacies from their roots as a team within a participating Covered Entity. Our careful and focused concentration on 340B has made us a well-respected resource for 340B eligible entities as a contract pharmacy third party administrator, independent auditor, consultant, and educator. We treat each client as if their 340B program is our own, offering the very same confident oversight we provide to our parent organization.
Today’s 340B challenges from manufacturers make it crucial for entities to have partners who can proactively navigate the changing
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OVERVIEW
Establishing a referral prescription capture program enables covered entities to broaden the reach of their 340B Drug Discount Program. Referral prescription capture can occur when patients of the covered entity utilize external specialists who are outside of the health system’s physician network.
Monitoring these opportunities not only increases the prescription volume that qualifies as 340B eligible, but the associated financial savings can help covered entities achieve the 340B mission to “stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services.”
HRSA Guidelines Regarding Outpatient Prescription Referrals
According to HRSA guidelines, a covered entity may refer a patient to a non-qualified 340B facility while maintaining responsibility for the patient’s care. This can occur if the patient receives care from a healthcare professional who is either employed by the covered entity or provides care under contractual or other arrangements (e.g., referral for consultation) such that the responsibility for the
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The word “innovation” gets tossed around so much these days that we almost forget its meaning—the introduction of new and different ideas for out-of-the-box problem solving that have meaningful impacts. Yet, innovation is different in every industry, and it’s essential in a field as complex as 340B.
To get a handle on it, we sat down with healthcare technology veteran Andrew Stevenson, VP of Product Strategy and Business Development, and 340B industry expert Christy Bryant, VP, Customer Service & Regulatory Affairs at Macro Helix, a third-party administrator that facilitates the 340B programs of more than 900 covered entities as well as hospital-owned and retail pharmacies. Responsible for supporting customer relationships, and driving the execution of critical innovation programs with Macro Helix’s customers, they have valuable insights to share for a 340B community faced with new challenges almost daily.
In a nutshell, what is Macro Helix? How do you help customers succeed with 340B?
Christy Bryant: We help healthcare entities maximize their 340B
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This strategy could save the 340B proceeds at your organization
Today, underinsured or uninsured patients who are undergoing treatment with a Gilead HIV treatment or preventative medication may be eligible to receive those medications at no cost through Gilead’s Advancing Access program. Under this program, covered entities are able to receive full 340B proceeds from these dispenses and can use these funds to support and expand critical community programs and outreach efforts.
As most Ryan White and STI grantee covered entities probably are aware, on January 1, 2022, Gilead will no longer reimburse pharmacies at full retail price under its Advancing Access program. This will eliminate nearly all the 340B proceeds you may be currently receiving under this program and could have a huge impact on your business and the
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While specialty drugs were used by less than 2% of the population in 2020, “they accounted for almost 51% of spending under the pharmacy benefit.”[1] Within your 340B program, these numbers can be even higher. On average, we see about six percent of volume resulting in close to fifty percent of savings for our clients. With numbers like this, it’s imperative to understand how to manage your 340B specialty contract pharmacies in order to maximize program value.
Below are five strategies to optimize your specialty pharmacy program:
1. Register your “ology’s”
There are six types of eligible clinics within a health system typically driving the majority of specialty value: dermatology, gastroenterology, rheumatology, endocrinology, neurology, and oncology. Medications dispensed through these clinics have high utilization and yield high savings. Ensuring these clinics are eligible and registered is the first, and most important strategy when capturing specialty value.
2. Set up your ideal specialty network
When developing a specialty network tailored to
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Q: Where did you grow up?
Conway, Pennsylvania (approximately 20 miles NW of Pittsburgh). I bleed black and gold – yes, I even cheer for the Pirates!
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Program integrity is crucial to the management of a covered entity’s 340B operations. Key components include knowing what is expected of the covered entity and having the right questions to ask your third party administrator about their practices and software. The purpose of this article is to highlight valuable objectives to have in place to ensure continuous program oversight and compliance with 340B guidelines and regulations. In this piece, I focus in particular on compliance and oversight related to patient eligibility and include important questions 340B providers must ask to both optimize their program performance and ensure compliance.
Program Integrity
What it Means
One of the driving principles of HRSA’s 340B Program Integrity Guide is that there must be a formalized process related to program operational oversight that will ensure compliance with 340B requirements.
To meet the definition of patient, covered entities must establish a relationship with their patients such that the entity will maintain records of the individuals’
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