MEDICAID and 340B
Are you concerned or curious about the potential impact of 340B on your Medicaid program?
Let’s face it. Successfully running a Medicaid pharmacy program isn’t easy. Adding in the 340B program with its need for managing multiple stakeholders and the requisite constant inspection has the possibility of adding another level complexity.
It doesn’t need to be that way. With the Astrolabe Claims Clearinghouse you can be assured of a worry-free integration with your providers’ participation in the 340B program while ensuring correct pricing and regulatory requirements are successfully met. And we’re able to do this at a price point that matches your needs.
- The 340B program is inherently complicated
and does not conform to standard, non-340B
pharmacy processes. As a result, Medicaid participation in the 340B program can be challenging.
- Pharmaceutical manufacturers are required to
provide 340B discounts on outpatient drugs
and to pay rebates for prescriptions paid by
Medicaid. However, manufacturers are explicitly
not subject to both a 340B discount and a
Medicaid rebate on the same sale (i.e.,
- Astrolabe is the sole independent and neutral
solution for preventing duplicate discounts,
while simultaneously enabling Medicaid program participation.
Need help Navigating 340B?
You may not have the time or budget to develop the in-house expertise required to effectively manage your participation in the 340B Program. Like most of our clients, you may only have a few minutes a week to spend on 340B. We understand that you’re busy. Let CiiTA be your external subject matter expert.
The Astrolabe Claims Clearinghouse is a Software as a Service (SaaS) offering that identifies 340B transactions, calculates contracted pricing, and manages funds. By coordinating with all the affected stakeholders, it ensures a seamless management of your plan’s participation in the 340B program
Every day, you work with providers motivated to provide quality and cost-effective care. That’s why the integration of 340B into your plan structure must be handled with tact and professionalism throughout the process.
Astrolabe is a collaborative and low-impact solution, allowing us to work in good faith with your providers to identify and reconcile 340B transactions in a neutral and thoughtful manner. We’ll work with all stakeholders to ensure that your 340B management plan fits your company’s and your providers’ expectations.
- The intent of the solution is to enable Medicaid and 340B cooperation to offer Medicaid savings, regulatory compliance, and to prevent duplicate discounts; therefore, the timing of data transfer and processing is critical.
- The Covered Entity (or agent) provides data in a
predetermined format on a specific schedule.
- Leveraging CiiTA’s unique and deep 340B expertise,
Astrolabe maps the data and performs a claims-
matching review to identify and flag all 340B claims
- Using an appropriate and transparent payment
algorithm, Astrolabe calculates the amount to be
recovered from the Covered Entity.
- Astrolabe impartially reports on 340B claims to the
Payer, as well as the Covered Entity and its agent.
- The Payer inserts the 340B modifier into the required
utilization file and submits it to the state using its
CiiTA’s data management processes are HIPAA, HITECH
and CCPA compliant.
CiiTA is the nationally recognized and neutral thought leader in offering transparent technology solutions for all stakeholders
in the 340B and Medicaid Drug Rebate Programs. Our proprietary tools and services help partners across the 340B Program realize results and remain compliant
Thorough, easy and also fun. I would say that the way of working with you and your folks is very awesome. There’s not many people that I work with that I would text on my own time and ask in a non-work context. I trust you 100%. You’re appropriate, thorough, and nobody calls you names. If anything they want to talk to you more and that’s a good thing.
From an analytical perspective, you understand the data in ways that we don’t. You layer on the statistical aspects that we don’t have.
It’s simple to take data and look at it and see a trend, but CiiTA layers in the knowledge of the covered entity that gives the trend its value.
Develop Your 340B Strategy
CiiTA has, through extensive experience, developed a set of best practices to help guide you through the creation of your 340B strategy. Download our process document to facilitate the development of your strategy.