Maintaining qualification for 340B.

After initial acceptance in the 340B Drug Pricing Program, hospitals and health systems should monitor and take steps to maintain their disproportionate share hospital status to continue to qualify for participation. Proactively managing the Supplemental Security Income (SSI) Ratio will ensure the organization avoids an unexpected decline in the Medicare portion of its 340B patient base. Even with the surge resulting from Medicaid expansion, tracking patient eligibility for Medicare/ SSI to ensure all patients who qualify are appropriately enrolled in the program is an important step in maintaining 340B program eligibility.

Fast track to 340B.

Hospitals that are newly qualified for the 340B Drug Pricing Program may have an opportunity for fast-track approval to participate in the program. Three steps are required to seize this opportunity: Use data analytics to assess current and future percentages of Medicaid utilization and eligibility for federal SSI cash benefits. Determine the feasibility of early cost report filing. Prepare appropriate documentation and undertake the initial enrollment process.

DSH payment under the ACA. Steps to receiving your fair share.

To obtain the appropriate levels of disproportionate share hospital and uncompensated care (UC) payment provided for under the Affordable Care Act, hospitals entitled to such payments should take the following steps: Move from episodic to continuous management of Medicaid-eligible days. Institute an automated subsystem for tracking changes in eligibility among the hospital's patients for aid through Medicaid, Supplemental Security. Income, or other sources of government assistance. Transition to using Worksheet S-10 as the basis for distribution of the UC payment.