340B or not 340B? Challenges in Properly Billing Drugs at Actual Acquisition Cost

    340B or not 340B? Challenges in Properly Billing Drugs at Actual Acquisition Cost
    CLE 90 min

    340B or not 340B? Challenges in Properly Billing Drugs at Actual Acquisition Cost

    • The download and on-demand online course for this title will be available for ABA Value Pass subscribers.
    • CD-ROM available to order 3 weeks before the program. Online courses and downloads will be available about a week after the program.
    • Recording date: August 6, 2014
    • Product Code: CET14CPBUMB
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    Almost half of all states now require providers to bill outpatient drugs at actual acquisition cost (AAC) and the requirements can differ when drugs are purchased at a 340B price.  Although historically these regulations have not been actively monitored or enforced, activities in several states over the last three years indicate this trend is changing.  The requirement to bill at AAC adds significant complexity to the already detailed process of billing state Medicaid programs for outpatient services.  Furthermore, providers that purchase drugs through the 340B program have an additional level of complexity as it pertains to calculating actual acquisition cost and designating drug purchases as originating through the 340B program. Not surprisingly, many providers have identified shortcomings in their billing processes that have resulted in billed charges for outpatient drugs being significantly higher than AAC and Medicaid overpaying for outpatient drugs.

    This program will help you gain valuable insight into identifying and addressing overpayments and managing self-disclosures of Medicaid overpayments on billed outpatient drugs.  Topics addressed include:

                 340B Drug Purchasing Program Basics

                 Overview of Actual Acquisition Cost ("AAC") Billing Requirements

                 Understanding the Intersection of 340B Purchasing & AAC Billing

                 We May Have Overpayments...Now What?

                 Key Considerations in Preparing a Self-Disclosure

                 Understanding All the Potential Audiences of Your Self-Disclosure

                 Identifying and Estimating Financial Impact of Erroneous Billed Charges

                 Designing a Compliant Billing Process for the Future

    Product Details


    Aaron Vandervelde, Helen Pfister


    ABACLE, Health Law Section

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    Publication Date

    8/6/2014 12:00:00 AM

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