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  3. Claims Processing System Issues
  4. 340B Federal Drug Pricing Program

340B Federal Drug Pricing Program 

 

HFS System Issue:

The 340B Federal Drug Pricing Program dispensing fee add-on is not being applied to claims submitted by Provider Type 52, Certified Health Departments.

Problem:

The Department released a notice on February 4, 2014 informing providers that in order to receive the $20 dispensing fee add-on, providers must identify 340B purchased drugs by reporting modifier "UD" in conjunction with the appropriate procedure code. Effective immediately, the provider charge should be the actual acquisition cost plus the $20 dispensing fee. Programming logic for the Certified Health Departments was not included in the claims processing system.

Providers Impacted:

Certified Health Departments

Procedure Codes Impacted:

All procedure codes for 340B purchased drugs reported with the modifier "UD".

Problem Begin Date:

Claims received February 4, 2014

Problem Fix Date:

Resolution for Impacted Claims:

The issue has not been resolved. Check this page for updates.