OIG
HHS OIG says CMS should monitor non-hospital covered entities' use of 340B modifiers when submitting Part B claims.

Inspector General Advises CMS to Monitor Non-Hospital 340B Entities’ Use of Modifiers on Part B Drug Claims

The U.S. Department of Health and Human Services Office of the Inspector General says the Centers for Medicare and Medicaid Services should monitor non-hospital 340B covered entities’ use of modifiers to identify 340B-priced drugs in Part B claims, as these entities get up to speed this year on using the modifiers which will be required for all Part B claims starting January 2024.

The Inflation Reduction Act allowed CMS to start collecting rebates on certain Part B drug claims, but stipulated that CMS must exclude from Part B rebate calculations drugs that were already subject to 340B discounts.

The U.S. Department of Health and Human Services Office of the Inspector General says the Centers for Medicare and Medicaid Services should monitor non-hospital 340B covered entities’ use of modifiers to identify 340B-priced drugs in Part B claims, as these entities get up to speed this year on using the modifiers which will be required for all Part B claims starting January 2024.

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