| REPORT COVER |
| TABLE OF CONTENTS |
| 1. OVERVIEW OF THE 340B DRUG DISCOUNT PROGRAM (Rev. June 2008) |
| |
| 1.1 |
Background |
| 1.2 |
Program Eligibility |
| 1.3 |
How Does the 340B Program Operate? |
| 1.4 |
Program Restrictions |
| 1.5 |
Savings |
| 1.6 |
Information Resources |
|
| 2. HOSPITAL ELIGIBILITY (Rev. June 2008) |
| |
| 2.1 |
Criterion One: Government Function |
| 2.2 |
Criterion Two: Medicare DSH Adjustment Percentage Above 11.75 |
| 2.3 |
Criterion Three: Purchase No Covered Outpatient Drugs Through GPOs |
| 2.4 |
DSH Hospital Enrollment Process |
| 2.5 |
Children's Hospitals |
|
| [The following chapters are available to SNHPA members only. Members click here to view additional chapters.] |
| 3. DEFINING THE SCOPE OF AN ELIGIBLE DSH HOSPITAL (Members Only) |
| |
| 3.1 |
Medicare Cost Report Test |
| 3.2 |
Medicare Provider-Based Test |
| 3.3 |
Home Health Agencies, Long-Term Care Facilities, Etc. |
| 3.4 |
Enrollment Process For New Outpatient Sites |
|
| 4. WHAT DRUGS ARE ELIGIBLE AND AT WHAT PRICE? (Members Only) |
| |
| 4.1 |
Medicaid Definition of Covered Outpatient Drugs |
| 4.2 |
Application to 340B Program |
| 4.3 |
340B Price Calculations |
| |
| 4.3.1 |
Scope of the GPO Exclusion |
| |
| 4.3.1.1 |
AMP |
| 4.3.1.2 |
Unit Rebate Amount |
| 4.3.1.3 |
“Best Price” |
|
| 4.3.2 |
Calculation Process and Timing |
|
| 4.4 |
New Drugs |
| 4.5 |
Confidentiality of 340B Prices |
| |
| 4.5.1 |
AMP and “Best Price” |
| 4.5.2 |
340B Ceiling Prices |
| 4.5.3 |
340B Actual Prices |
|
|
| 5. WHO MAY RECEIVE THE DISCOUNTED DRUGS? (Members Only) |
| 6. MEDICAID BILLING REQUIREMENTS (Members Only) |
| 7. MEDICARE PRESCRIPTION DRUG BENEFIT AND 340B (Members Only) |
| 8. INVENTORY MANAGEMENT (Members Only) |
| |
| 8.1 |
Relevant 340B Standards |
| 8.2 |
Stock Replacement |
| |
| 8.2.1 |
NDC-by-NDC Substitution |
| 8.2.2 |
Reverse Substitution |
|
| 8.3 |
Meeting the Challenge of NDC-by-NDC Substitution |
| |
| 8.3.1 |
Inadequate Tracking Systems |
| 8.3.2 |
Unavailability of Replacement Product |
| 8.3.3 |
Generic Substitution |
|
| 8.4 |
Emergency Room Drugs |
| 8.5 |
Cherry Picking |
| 8.6 |
Future Considerations |
|
| 9. CONTRACT PHARMACIES (Members Only) |
| 10. ALTERNATIVE METHODS DEMONSTRATION PROJECTS (Members Only) |
| 11. NEGOTIATING ADDITIONAL DISCOUNTS (Members Only) |
| 12. MANUFACTURER NON-COMPLIANCE (Members Only) |
| 13. COVERED ENTITY COMPLIANCE (Members Only) |
| APPENDIX |
Washington, DC 20005 
