340B Pulse

340B operations management is the continuous tracking and execution of contract pharmacy claims, duplicate discount prevention, and inventory replenishment to maintain HRSA eligibility. In this episode of 340B Pulse, we break down exactly how leading covered entities manage operational complexity.Is your 340B program rapidly expanding while your compliance oversight lags behind? You are putting your entire savings margin at risk.In this episode of 340B Pulse, NorthArc's Muhammad Atif and Salman Asif sit down with Robert Ferraro, CEO of Ravin Consultants. Robert manages 340B operations for nearly 80 covered entities and drops a masterclass on navigating the increasing pressure of 340B transparency reporting and rebate pilot models. We dive deep into the specific operational bottlenecks holding programs back, including how inexpensive EMR setups stifle your ability to validate claims and how failing to perform a 10% monthly claims check can lead to devastating HRSA findings. NorthArc helps covered entities establish custom backend data infrastructure and Agentic AI controls to ensure your 340B operations remain tightly governed, highly visible, and perfectly audit-ready without disrupting your existing TPA relationships.- 00:00 - Introduction to 340B Pulse & NorthArc- 03:57 - Robert Ferraro's 340B Operator Journey- 08:02 - How the 340B Rebate Pilot Forces Traceability- 12:12 - Approaching 340B Transparency & State Reporting- 15:28 - Creative 340B Savings Utilization (Food Banks & Mobile Clinics)- 19:43 - The Biggest Bottlenecks to Scaling: EMRs & Personnel- 24:49 - Day-to-Day 340B Compliance and Audit Checkpoints- 28:11 - Preventing Drug Diversion through Closed-Loop Referrals- 33:25 - The Most Devastating Avoidable Leadership Mistakes- 36:26 - How to Reach Out to Ravin Consultants & NorthArcWhat is a 340B closed-loop referral?A 340B closed-loop referral is a documented workflow where a covered entity refers a patient to an outside specialist and subsequently receives and files the specialist's clinical progress notes back into their EMR to prove continuous ownership of care.How do covered entities use 340B savings?Covered entities use 340B savings by aggressively expanding local healthcare access through fully funded community food banks, free transportation programs (like bus or Lyft vouchers), and specialized mobile mental health clinics.What is the biggest operational bottleneck in 340B scaling?The biggest operational bottleneck in 340B scaling is utilizing an inexpensive or rigid EMR platform that lacks deep technological integration abilities, slowing down the extraction of ICD-10 codes needed to accurately evaluate patient eligibility.#340B #340BProgram #HealthcareCompliance #PharmacyOperations #HealthcareTech #HealthTech #NorthArcHealth #DataEngineering #PharmacyDirector

What is a 340B contract pharmacy program? A 340B contract pharmacy program is an operational partnership where a covered entity utilizes an external pharmacy to dispense discounted outpatient drugs to eligible patients. To maintain compliance and profitability, entities must rigorously manage inventory, dispensing fees, and TPA audits.The friction between covered entities and contract pharmacies is costing the 340B ecosystem millions. In this episode of 340B Pulse, Mohammad Atif and Hassan sit down with Lyssa Limbrecht-Mosh, founder of Optimal340B, to expose the operational realities of 340B pharmacy management. Lyssa breaks down why TPA auto-ordering systems trigger catastrophic inventory swell, how to structure fair dispensing fees, and why auditing uncaptured claims is the fastest way to recover lost revenue. We also discuss the looming threat of the Maximum Fair Price (MFP) regulations and the controversial shift toward a rebate model.00:00 - Introduction to 340B Pulse 04:49 - Lyssa's Journey into 340B Compliance 06:41 - What Defines a Healthy Contract Pharmacy? 08:19 - The Disconnect in Healthcare Reimbursement 11:34 - The Danger of TPA Auto-Ordering & Inventory Swell 18:22 - Structuring Fair Pharmacy Dispensing Fees 21:32 - Real Example: Recovering $1.3 Million Through Audits 23:19 - 3 Immediate Steps to Improve Your 340B Program 25:03 - The Role of AI and Custom Technology in 340B 27:24 - Future Threats: MFP and the 340B Rebate Model 29:20 - How to Connect with Optimal340BHow do you prevent 340B inventory swell? To prevent 340B inventory swell, covered entities must communicate with their contract pharmacies, avoid rigid auto-ordering for low-volume specialty drugs, and allow pharmacies visibility into replenishment schedules.Why are 340B dispensing fees important? 340B dispensing fees compensate the contract pharmacy for the operational burden of managing dual inventories and processing complex 340B claims, ensuring the partnership remains financially viable for the pharmacy.What is the 340B rebate model? The 340B rebate model is a proposed system where covered entities purchase drugs at full wholesale acquisition cost (WAC) and subsequently request a rebate from the manufacturer, significantly impacting cash flow.340B #HealthcareCompliance #PharmacyOperations #ContractPharmacy #NorthArc #HealthcareTechnology #340BAudits #Optimal340B #HealthTech

340B audit readiness is the operational ability of a covered entity to maintain explicit, trackable evidence of patient eligibility, pharmacy dispensation, and drug accumulation logic, proving immediate HRSA compliance on any given day.Are you relying on end-of-year mock audits to save your 340B program from HRSA scrutiny? This week on *340B Pulse*, host Muhammad Atif stands alongside Salman Asif to explore the realities of operational compliance with Carrie Yannarella. With decades of outpatient clinical operations experience, Carrie breaks down why relying on reactive tracking guarantees an audit failure. Rather than scrambling to find missing referral logs and unmapped Medicaid modifiers hours before an external audit, Carrie teaches program managers how to establish a continuous, frictionless monthly rhythm.If you are a covered entity executive or a pharmacy leader exhausted by compliance burnout, this episode offers a practical, step-by-step masterclass on how to deploy TPA platforms efficiently, sample the right claims, and force cross-functional accountability without overwhelming your staff.What You’ll Learn in This Episode- The definition of true 340B audit readiness and why reactive models fail.- How to efficiently identify drug diversion through monthly purchasing variance reviews.- The precise methodology required for targeted 10% claim sampling.- How to structure reporting handoffs between Pharmacy, Clinics, and Finance correctly.- Essential project management strategies for defeating compliance burnout.[00:00] – Intro to 340B Pulse and NorthArc Health[04:49] – Understanding the Mindset Behind Daily Audit Readiness[06:24] – How to Actively Monitor High-Risk Dispensations [07:48] – The Danger of Random Sampling vs. Targeted Sampling[10:50] – Breaking Down Departmental Silos for Perfect Traceability[14:55] – The Crucial Artifacts You Must Keep Ready for HRSA[16:33] – Preventing Burnout Using Basic Technology Tools[18:00] – Closing Notes and the Importance of Agentic AIQ: What exactly is 340B audit readiness?A: Audit readiness is a proactive operational philosophy ensuring that a covered entity tracks and documents every step of their 340B workflow so perfectly that they could successfully pass an unannounced HRSA compliance audit immediately. Q: Who is responsible for 340B program compliance?A: Program compliance is a deeply cross-functional responsibility requiring Pharmacy to control drug builds, Clinics to control referral documentation, and Finance to manage the ultimate auditing and claims retrieval. Q: Why do covered entities fail HRSA audits?A: Covered entities typically fail HRSA audits due to systemic drug diversion, meaning they lack the concrete internal clinical systems, like EMR data interoperability, needed to prove they actively maintained medical responsibility for the patients receiving discounted medications. Brought to you by NorthArc Health. We engineer intelligent Agentic AI software that drives unshakeable administrative visibility. Reach out for a consultation today.

Are your 340B operations fully optimized, or are you secretly missing massive savings? In this episode of 340B Pulse, Lisa Nezneski, Founder of 340B Orphan Drug Solutions, explains the "Orphan Drug Blind Spot." Many rural and community hospitals mistakenly assume orphan drugs are strictly excluded from their programs, but discretionary manufacturer pricing can unlock $200K to $450K in hidden revenue for your hospital every year.If an executive asked you right now if your hospital was fully maximizing its 340B savings, your answer would probably be "Yes." But if you operate a Critical Access Hospital (CAH), a Sole Community Hospital (SCH), or a Rural Referral Center (RRC), your program might still be leaving hundreds of thousands of dollars on the table. Join hosts Mohamed Atif and Salman Asif as they sit down with 340B veteran Lisa Rizenki to unpack this massive, widely misunderstood opportunity. This operational deep-dive reveals why orphan drugs routinely make up 50% to 75% of your total drug budget, the truth about discretionary manufacturer discounts, and why your Third-Party Administrator (TPA) might be automatically blocking these life-changing accumulations.Discover how to safely run a "first-pass" validation without disrupting operations, reframe the discovery of missing savings for hospital administration, and ultimately turn regulatory complexity into a predictable strategy that funds vital community health programs.Subscribe to 340B Pulse for more operator-level conversations on program compliance, hospital finance, and healthcare technology!00:00 - Introduction to 340B Pulse & Today's Topic01:45 - What is the 340B Orphan Drug Blind Spot?06:43 - The Discretionary Pricing Misconception Explained13:35 - The 50% Rule & Avoiding The $75,000 Weekend Mistake18:10 - Identifying TPA Bottlenecks & Accumulator Setup Issues26:57 - The Secret to Pitching Administrators & The CFO28:05 - Why Pharmacists Must Learn to Sell32:19 - The "Bless Your Heart" TPA Software Blocker Story38:50 - The $450,000 Success Story (Case Study)49:04 - The $200 vs. $2 Gleevec Pricing Reality50:37 - Overcoming the Fear of Finding "Missed" Savings (Becoming the Hero)53:30 - Final Thoughts & Closing ActionsWhat is the 340B Orphan Drug Blind Spot? Many Critical Access and Sole Community Hospitals mistakenly assume orphan drugs are strictly excluded from their 340B programs and cannot receive discounts. In reality, manufacturers often offer discretionary discounts that hospitals fail to claim, leaving significant money on the table.How much in savings are hospitals missing from orphan drugs?On average, audits reveal that hospitals frequently miss between $200,000 and $450,000 annually due to misconfigured TPA setups and blocked accumulations regarding orphan drug claims.How can a hospital fix missed orphan drug savings?Covered Entities can recapture these savings by utilizing tracking tools like the 340B Orphan Drug Estimator, directly managing IT communication queues with TPAs, and properly routing NDCs to align with discretionary manufacturer pricing.#340B #OrphanDrugs #HospitalFinance #HealthcareOperations #PharmacyBenefitManager #HealthcareTech #RuralHealth #CriticalAccessHospital #340BPulse #NorthArcHealth

Are Pharmacy Benefit Managers (PBMs) saving your healthcare organization money, or are they a hidden operational cost driver? In this episode of 340B Pulse, hosts Muhammad Atif and Hassaan sit down with Dr. Jonathon Harrison, President and CEO of Wellyfe, to expose the realities of traditional PBM contracts. Dr. Harrison pulls back the curtain on how vertical integration has shifted the PBM model away from saving employers money and towards retaining multiple hidden margin layers.Tune in to learn how shifting to a Direct Pharmacy Care model can immediately recover up to 60% in savings for 340B operations, and why health systems must rely on custom AI-driven reporting to truly audit their pharmacy expenditures. What You’ll Learn in This Episode:- The truth behind arbitrary $8,000 "specialty drug" markups.- The 15 hidden revenue streams PBMs use to collect your margins.- Why the incoming 340B rebate pilot programs will overwhelmingly punish small FQHCs.- The top 5 non-negotiable questions every CFO must ask before their next PBM contract renewal.- How leveraging custom Agentic AI eliminates dashboard fatigue and returns actionable, CFO-grade analytics.Future-Proof Your Program with NorthArc HealthNavigating PBM contracts and mitigating operational burdens requires a sophisticated, technological approach. Explore how NorthArc's custom Agentic AI solutions can strengthen your program visibility and streamline your workflows: 🌐 [NorthArc Health](https://northarchealth.com)## Interactive Timestamps / Chapters(00:00) - Introduction to 340B Pulse & Today’s Topic(02:50) - Who is Dr. Jonathon Harrison? (06:20) - The True Intended Motive of Modern PBMs(07:39) - Why the 340B Rebate Model is Failing(09:43) - Minimum Operational Controls for Covered Entities(11:30) - Can PBMs Actually Cut Hospital Costs?(15:20) - Exposing the 15 Hidden PBM Revenue Streams(18:00) - How Rebates Distort Formulary Placement(20:13) - The Specialty Drug Markups Secret(23:20) - Why You Shouldn't Rely on "Standard Transparency"(25:00) - Top 5 Questions Every CFO Must Ask Their PBM(30:11) - Debunking the PBM "Transparency" Myth(32:00) - Defeating Dashboard Fatigue with AI(34:06) - How Organizations Recover 60% of Pharmacy Margins(35:42) - Restoring the Community Pharmacy Model