ACE 340B Patient Definition & Eligibility 3

Question 1

A Ryan White HIV/AIDS Program grantee is determining whether a patient qualifies for 340B. Which factor is MOST critical in this determination?

Accepted Answer

Whether the covered entity maintains the patient's health records and provides ongoing care

Answer

Regardless of the type of covered entity, the core patient definition requires an established care relationship with maintained health records and ongoing care responsibility.

Question 2

What is the significance of the 'responsible for ongoing care' requirement in the 340B patient definition?

Accepted Answer

It ensures the prescribing provider's accountability for the patient's care remains with the covered entity

Answer

The 'responsible for ongoing care' requirement ensures the care relationship is anchored within the covered entity's context, not merely a one-time external referral with no continued accountability.

Question 3

What type of records must a covered entity maintain to demonstrate patient eligibility during a 340B audit?

Accepted Answer

Medical records or other documentation establishing the patient care relationship

Answer

Covered entities must maintain records such as medical records or health documentation that establish the patient care relationship to demonstrate compliance during audits.

Question 4

A covered entity's 340B coordinator discovers that 340B drugs were dispensed to employees of the covered entity who are not registered patients. This represents:

Accepted Answer

A potential diversion violation requiring immediate corrective action

Answer

Dispensing 340B drugs to individuals who do not qualify as patients—including employees—constitutes diversion, a serious compliance violation that can result in program termination.

Question 5

What term describes the practice of intentionally excluding Medicaid claims from 340B drug purchases to avoid duplicate discounts?

Accepted Answer

Carve-out

Answer

Carve-out refers to excluding Medicaid fee-for-service patients or claims from 340B drug purchases, thereby preventing duplicate discounts on those drug units.

(ACE) Apexus Certified Expert Practice Test

(ACE) Apexus Certified Expert Practice Test

ACE 340B Patient Definition & Eligibility 3