These are the foundational terms that define what the 340B program is, who can participate, and which agency governs it. If you’re evaluating compliance risk or vendor support, start here as every audit and savings decision builds on these definitions.
A hospital certified to receive cost-based Medicare reimbursement, designed to improve financial performance of rural hospitals and reduce closures, eligible for 340B participation with a DSH adjustment percentage of at least 8%.
A hospital that serves a significantly disproportionate number of low-income patients and receives Medicare DSH adjustment payments, eligible for 340B participation with a DSH adjustment percentage greater than 11.75% and subject to the GPO Prohibition.
A community-based health care provider receiving HRSA Health Center Program funding to provide primary care in underserved areas on a sliding fee scale, eligible for 340B participation and not subject to the GPO Prohibition.
An individual with deep expertise in a specific domain, used in the 340B context to describe consultants, auditors, and compliance professionals with specialized knowledge of the 340B program.
A national advocacy organization representing Title X family planning providers, which advocates for policies supporting family planning programs including 340B access for Title X clinics.
A federal-state partnership program providing health insurance coverage to children in families with incomes too high for Medicaid but who cannot afford private insurance, relevant to 340B as a payer for some covered entity patients.
A federal program providing monthly payments to low-income individuals who are aged, blind, or disabled, used in the DSH adjustment percentage calculation as a proxy for low-income Medicare patient volume.
A metropolitan area designated by the federal government as having a high HIV/AIDS case count, qualifying organizations in that area for Ryan White Part A funding and 340B participation.
A hospital area or department that serves both inpatient and outpatient patients, creating compliance complexity for 340B programs because only outpatient drug use is eligible for 340B pricing.
A Medicare designation that allows hospital outpatient departments to bill a facility fee in addition to a professional fee, which is relevant to 340B child site eligibility for offsite hospital outpatient facilities.
