Overview
Congress enacted the 340B Drug Pricing Program in 1992 to lower drug costs for safety-net providers that serve the nation’s most vulnerable patient populations. Congress intended the 340B Program to help these providers “stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services.”
Under the program, which is administered by the Health Resources and Services Administration’s (HRSA) Office of Pharmacy Affairs, pharmaceutical manufacturers are required to extend discounts on covered outpatient drugs to eligible providers as a condition of participating in the Medicaid and Medicare Part B markets.
The 340B Program is a discount program that operates at a marginal administrative cost, and reduces federal, state, and local health care spending by supporting providers that deliver necessary care to underserved populations.
Eligibility
The 340B statute defines the types of safety-net providers, called “covered entities,” that are eligible to participate in the 340B Program. The types of providers eligible to participate in the program include: Community Health Centers, Ryan White Providers, Hospitals, and Specialized (black lung, etc.).
Who Benefits from 340B?
The significant pharmacy discounts available under the 340B Program allow covered entities to provide and expand needed services that otherwise would not be available in the communities in which they serve.
Many covered entities use 340B savings to cover the cost of uncompensated care for uninsured and underinsured patients. For patients, this means lifesaving medications at reduced or no cost, expanded access to community-based primary and specialty care, help managing chronic conditions, and other community health programs.
Governor Newsom’s Executive Order N-01-19
In January 2019, California Governor Gavin Newsom signed Executive Order N-01-19, which directs the Department of Health Care Services (DHCS) to create a single-purchaser system of drugs in California by January 2021. This would transition all pharmacy services for Medi-Cal from managed care to Fee-For-Service (FFS) by January 2021.
Governor Newsom's proposed 20/21 state budget includes $105 million for a new Supplemental Payment Pool for Non-Hospital 340B Clinics effective 1/1/21.With the creation, and funding, of the new Supplemental Payment Pool for Non-Hospital 340B Clinics, effective 1/21/21, the administration creates a pathway to guarantee community clinics and health centers can maintain vital services and programs previously funded through 340B program participation.
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