ACE Financial Management & Duplicate Discount Prevention Flashcards
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Read the first 6 ACE Financial Management & Duplicate Discount Prevention flashcards as text
How is the 340B ceiling price for a drug generally calculated?
Answer: Average Manufacturer Price (AMP) minus the Unit Rebate Amount (URA)
The 340B ceiling price equals the Average Manufacturer Price (AMP) minus the Unit Rebate Amount (URA), aligning it with the Medicaid rebate calculation.
What is the primary financial benefit that 340B covered entities derive from the program?
Answer: The ability to purchase outpatient drugs at significantly discounted prices, generating savings
The core financial benefit is the ability to purchase covered outpatient drugs at 340B ceiling prices, which are substantially below market prices, generating savings the entity can reinvest.
According to the 340B statute, how should savings generated by the program be used?
Answer: Reinvested to expand services and reduce costs for vulnerable and underserved patients
The 340B program's intent is for savings to be reinvested into expanding services, reducing drug costs, and improving care for underserved and low-income patients.
What financial metric is most commonly used by covered entities to demonstrate the value of their 340B program?
Answer: 340B savings (the difference between acquisition cost and reimbursement or market price)
340B savings — calculated as the spread between the discounted 340B acquisition cost and the reimbursement or market price — is the primary metric used to quantify program financial value.
What is the role of the Office of Pharmacy Affairs (OPA) in relation to 340B ceiling prices?
Answer: OPA oversees the 340B program and maintains the ceiling price database accessible to covered entities
The Office of Pharmacy Affairs (OPA), a division of HRSA, administers the 340B program and provides covered entities access to the ceiling price database to verify they are not overcharged.
If a manufacturer charges a covered entity more than the 340B ceiling price, what recourse does the entity have?
Answer: Submit a dispute through the HRSA Administrative Dispute Resolution (ADR) process
Covered entities that are overcharged above the 340B ceiling price may seek relief through HRSA's Administrative Dispute Resolution (ADR) process.