Real-time 340B prescription processing is now more important than ever.
Tomorrow, April 1st, New York State launches a rule that eliminates use of the HRSA Medicaid Exclusion File (MEF) in determining which prescriptions are to be eliminated from the rebate program because they were filled with 340B-priced drug stock.
The following are key points on the impact of the New York State rule, its ramifications on a national level, and ScriptPro’s solution:
- Covered Entities using split-billing software that identifies 340B eligible Rx after-the-fact now run risk of “double dipping”
- Heightened audit risk likely will push some covered entities to inconvenient, detrimental, and costly fixes, such as “carving-out” Medicaid or heavily screening patients
- While this rule will impact New York pharmacies starting tomorrow, it is not unique to New York; there are complex 340B rules in other states as well, and more will come
- ScriptPro’s 340B system operates in real time to identify 340B prescriptions and automatically sets correct claim codes, which eliminates the need for the MEF – precisely in line with the new NYS Medicaid rule
The ability to make a 340B status determination immediately while the pharmacy is processing the prescription is vital to reducing audit risk and disqualification, managing accurate and appropriate inventories, and enabling pharmacy staff to optimally serve all patients.
ScriptPro’s 340B solution solves the Medicaid-340B dilemma.