340B Unscripted

Ep 55 | All About 340B Modifiers

In this episode, Greg and Rob discuss the various uses of 340B billing modifiers. They’ll discuss some general considerations around what billing modifiers are used for, highlight differences between hospital/clinic and pharmacy billing in terms of applying correct modifiers, and debate different aspects of Medicaid and Medicare billing modifier requirements.  It’s another heavy duty 340B-operations focused episode. 

Ep 54 | 340B Operations Discussion – “Clean Site” Locations

In this episode, Greg and Rob get back to 340B basics and have a conversation around the concept of “clean site” 340B-only locations.  They discuss what “clean site” means in the world of 340B, what the benefits of the approach are, what some of the risks and obstacles are from a compliance perspective, and share some anecdotes from past experiences working with these types of 340B universes.
In the intro, the guys discuss a couple of recent developments – most notably, J&J's response to HRSA's enforcement letter regarding the proposed rebate model.
 
Register for our upcoming webinar "Revolutionizing Pharmacy Procurement: Unlocking Savings with Automated NDC Selection": https://attendee.gotowebinar.com/register/1835792334721804630?source=340BUnscripted

Ep 53 | J&J 340B Rebate Model Follow-Up Discussion

In this episode, Greg and Rob catch up on developments surrounding the J&J 340B rebate proposal, including HRSA’s response. They’ll address some outstanding questions from the recent SpendMend webinar on the topic.
In the intro, they recap some updates regarding contract pharmacy litigation and thoughts on how DSCSA and product serialization data might impact 340B operations.
If you missed it before, you can watch our webinar on the J&J 340B rebate model here: https://ww2.spendmend.com/webinar-jj-340b-rebate-model-what-covered-entities-need-to-know/

Ep 52 | 340B Smorgasbord - Contract Pharmacy Legislation, ADR, Section 1115 Waiver Days & 340B Rebate Models

In this episode, Greg and Rob are joined by healthcare attorney and 340B veteran Barbara Straub Williams.  They cover a variety of topics, including an update on litigation targeting state-level contract pharmacy laws (21:18), navigating manufacturer audits and ADR claim submissions (38:47), a recent court ruling related to exclusion of Section 1115 wavier days from DSH percentage calculations (50:53), and last but not least a recent policy notice by J&J to covered entities announcing a 340B rebate model for two of their products  (58:17).
 
In the intro, the guys offer some preliminary thoughts on the topics at hand this week.
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Register for our upcoming webinar on the J&J 340B Rebate Model - https://attendee.gotowebinar.com/register/1165611409822890584?source=340B+Unscripted

Ep 51 | CMS Medicaid Drug Rebate Program & “Covered Outpatient Drug” Definition

In this episode, Greg and Rob are joined by healthcare attorney Todd Nova to discuss a proposed rule change put forth by CMS in 2023 regarding the Medicaid Drug Rebate Program (MDRP), which includes a potential change to the definition of “covered outpatient drug”. They’ll discuss how covered entities have historically interpreted the definition of covered outpatient drugs, and what impact might come from CMS’s proposed change in this definition. Greg and Rob also get Todd’s take on recent HRSA audit activity in a post-Genesis 340B environment.
In the intro, the guys discuss the recent announcement of Medicare prices on the first 10 drugs subject to IRA-mandated drug price negotiations, a court ruling in Texas over DSH% calculation and use of Section 1115 waiver days, and changes to claims submission via 340B ESP. 

Ep 50 | 340B Q&A with Hoopii

This is our 50th episode, and it marks the 2 year anniversary of the 340B Unscripted Podcast. To mark the occasion, Greg asks Rob a hodgepodge of 340B-related questions including entity-owned vs contract pharmacy considerations, out-of-state Medicaid carve-out challenges, “class of trade”, referral capture documentation standards and how CEs should keep an eye on their OPAIS registration. Thanks everyone for listening, and here’s to another 50 episodes!

Ep 49 | HRSA Audit Trends and Manufacturer Audit Activity – Conversation with Emily Cook

In this episode, Greg and Rob have another repeat guest!  Healthcare attorney Emily Cook shares some insights gained from the 340B Coalition Summer Conference around recent HRSA audit patterns (08:37) and a cluster of manufacturer audits of 340B covered entities (27:46).In the intro, the guys touch base on some 340B newsworthy developments in the contract pharmacy and legislative space.Email us your 340B-related questions at 340BUnscripted@spendmend.com

Ep 48 | 2024 Midyear 340B Review - Conversation with Ted Slafsky

In this episode, Greg and Rob gear up for the 340B Summer Coalition conference, and are joined again by Ted Slafsky to discuss various 340B developments from the first half of 2024.  They’ll discuss the ongoing contract pharmacy saga between entities and manufacturers, debate the future of proposed federal legislation addressing 340B Program reform, and recap pertinent court cases with both direct and indirect impact on 340B. In the intro, the guys catch up on updated contract pharmacy restrictions and recent audit experiences.  Come find us at Booth #717 at the 2024 340B Coalition Summer Conference!Listeners are welcome to use code “SpendMend25” to receive a 25% discount for new subscriptions to 340B Report. Visit https://340breport.com/