TPA (Third-Party Administrator)
An organization that contracts with covered entities and pharmacies to manage the operational aspects of contract pharmacy arrangements, including patient eligibility determination, claims processing, inventory management, and data reporting.
Read MoreContract Pharmacy (340B)
An independent or chain pharmacy that has a written agreement with a 340B covered entity to dispense 340B-priced drugs to the covered entity’s eligible patients on its behalf.
Read MoreFederally Qualified Health Center (FQHC)
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.
Read MoreCritical Access Hospital (CAH)
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%.
Read MoreDisproportionate Share Hospital (DSH)
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.
Read MoreClaims Reconciliation (340B)
The process of comparing 340B drug purchasing records against dispensing and billing records to verify accuracy, identify discrepancies, and ensure that all 340B transactions are properly documented and accounted for.
Read MorePolicies & Procedures Review (340B)
A structured assessment of a covered entity’s 340B policies and procedures to verify they are current, comprehensive, and aligned with HRSA program requirements and the entity’s actual operational practices.
Read MoreMTM (Medication Therapy Management)
A service provided by pharmacists to optimize drug therapy and improve patient outcomes, which may be offered as part of a covered entity’s 340B program services.
Read MoreNABP (National Association of Boards of Pharmacy)
An independent organization that supports state boards of pharmacy in protecting public health by developing pharmacy licensing standards and accreditation programs, relevant to 340B as a source of pharmacy regulatory standards.
Read MoreCDM (Charge Description Master)
A comprehensive list of all services, procedures, and drugs that a hospital or health system can bill to payers, used in 340B programs to ensure that drugs purchased at 340B prices are billed correctly.
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