340B
True or False - Active 340B covered entities must recertify their eligibility annually to remain in the 340B Program.
True
Record of all medication prescriptions that were submitted electronically by a provider
ePrescribe Data
During this phase of a project, we generally conduct interviews.
Assessment
How many digits should an NDC be?
11
This drug type usually accounts for 23% of specialty drugs
LDD (Limited Distribution Drugs)
An arrangement in which the 340B covered entity signs a written contract with a pharmacy to provide pharmacy services
Contract Pharmacy
List of physicians within the organization who are employed or contracted to provide care
Provider List
A pharmacy only project is called what?
A Stand-Alone Engagement
What resource can be used to help identify child sites of a Covered Entity and contract pharmacy relationships?
OPA Website
True or False – Specialty Drugs are generally orphan drugs
True
Are Orphan drugs considered covered outpatient drugs for rural referral centers and sole community hospitals?
No
This data can be used to figure out the cost of a specific drug depending on the account. It is provided by the wholesaler
Catalog data
A project with multiple solution groups?
Integrated Project
What does PBM stand for?
Pharmacy Benefit Manager
What is the greatest barrier to fill a patients specialty medicine?
Payer/access to the drug
What DSH % does a hospital need to qualify in the 340B Program as a DSH Hospital?
> 11.75%
Report is filed annually which provides information on which departments/locations within the hospital are eligible for program participation
Medicare Cost Report
What is the name of the internal discussion that should take place prior to kicking off an engagement to understand roles and responsibilities?
Expectations Discussion
Which drug database do we use on the Huron Pharmacy team?
Medispan/Multum
What are the two types of accreditations a specialty pharmacy can obtain?
URAC ACHC
When can a hospital complete the online registration process to enroll into the 340B program?
First two weeks of any calendar quarter (January 1-15, April 1-15, July 1-15, and October 1-15)
Where can clients upload data when submitting claims?
340B ESP
What is the final project document for a completed initiative? It can document the savings that were tracked.
Benefit Packet
Verity/Macro Helix are an example of _____.
TPA (Third party Administrator) Or Split Billing Software
True or False - NDCs are a standard requirement for both medical benefit and pharmacy benefit billing
False - Pharmacy benefit billing uses NDCs, and medical benefit billing uses HCPCS and CPT codes
Equal to the average manufacture price subtracted by the Medicaid unit rebate amount
340B Ceiling Price
How much cheaper is 340B versus GPO?
~30% to 50 %
For Implementation, what are the three phases of a project life cycle?
Identification, Implementation, and Monitor/Transition
Which 4 file types are used when preparing a Snapshot for Portland for compliance engagements?
ADT, ePrescribe, Provider List, Claims File
Commercial plan’s specialty pharmacy networks decisions are made by _____.
PBMs (generally for fully insured plans) or plan sponsors (generally for self-insured plans)