1. INTEGRITY ● ACCESS ● VALUE 1 Federal Update: PSSC Pharmacy Services Support Center Promoting Value, Integrity & Access Lisa Scholz, PharmD, MBA Senior Director, Health Resources and Services Administration Pharmacy Services Support Center June 17, 2010 Kansas City, MO NRHA Medication Use

2. INTEGRITY ● ACCESS ● VALUE 2 Washington Snow! Center Dec 2009 18 inches Feb 2010 24 inches

3. INTEGRITY ● ACCESS ● VALUE 3 Washington Snow Shoveling! Center Dec 2009 Dustpan Feb 2010 Shovel

4. VALUE ● INTEGRITY ● ACCESS 4 Learning Objectives 340B Statistics 1 PSSC Core Business Elements 2 Information Analysis and Management 34 Relationships and Networking 5 Frequently Asked Questions 6 Interactive Time 7 Contacts 8 Policy Analysis

5. VALUE ● INTEGRITY ● ACCESS The Three Legs of the stool… 3 snowpeople! 5 Lisa(PSSC) Jimmy(OPA) Chris(PVP)

6. VALUE ● INTEGRITY ● ACCESS Our Mission is OPA’s Mission Optimize the value of the 340B Program and provide clinically and cost effective pharmacy services that improve medication use and advance patient care.

7. VALUE ● INTEGRITY ● ACCESS 7 340B Entity Eligibility Consolidated Health Centers Federally Qualified Health Center, or FQHC look-alikes Family planning (Title X) Ryan White Care Act (Parts A, B, C, D) grantees Black lung clinics Comprehensive hemophilia diagnostic treatment centers Native Hawaiian health centers Urban Indian organizations Certified tuberculosis clinics Certain disproportionate share hospitals (>11.75%) Certified sexually transmitted disease clinics Children’s Hospitals

8. VALUE ● INTEGRITY ● ACCESS 88 340B Entity Locations by State 663 300 67 1391 908 371 562 341 269 583 117 14,504 Total Entities 90 HI 71AK 441 242 216 105 289 108 43 48 110 179 243 49 608 220 410804 431 367 66 351 85 124 144 141 553 58 489 339 277 MD 112 CT 194 38 DC 46 NH 65 VT 211 NJ 50 DE 49 RI 307 MA 10 VI 89 PR American Samoa 1 FS of Micronesia 2 Guam 6 Marshall Islands 4 Palau 1

9. VALUE ● INTEGRITY ● ACCESS 340B NEW covered entities Freestanding Cancer hospitals with a disproportionate share > 11.75% Critical Access Hospitals Rural Referral Centers with a disproportionate share > 8% Sole Community Hospitals with a disproportionate share > 8% 9

10. VALUE ● INTEGRITY ● ACCESS Interactive Time! As a covered entity, who has primary responsibility for carrying out the 340B program? A.Prime Vendor Program B.Pharmacy Services Support Center C.Health Resources and Services Administration-Health Systems Bureau D.Office of Pharmacy Affairs E.All of the Above 10

11. VALUE ● INTEGRITY ● ACCESS 11 PSSC Core Business Elements Information analysis and management Policy analysis Networking and Relationships

12. VALUE ● INTEGRITY ● ACCESS Information Analysis and Management http://pssc.aphanet.org/ PSSC Website

13. VALUE ● INTEGRITY ● ACCESS Let us help you simplify the complex…

14. VALUE ● INTEGRITY ● ACCESS Information Analysis and Management Knowledge Management System

15. VALUE ● INTEGRITY ● ACCESS 15 Information Analysis and Management PSSC Call Center 1-800-628-6297 PSSC@aphanet.org or

16. VALUE ● INTEGRITY ● ACCESS 16 340B PSSC Inquiries by State 343 89 62 702 181 164 220 76 74 139 79 Total Inquiries* 52 HI 44AK 203 144 116 34 70 40 39 15 55 63 56 16 348 126 54 129 141 69 45 63 66 59 87 104 345 50 180 248 96 MD 68 CT 40 52 DC 17 NH 28 VT 178 NJ 25 DE 29 RI 70 MA 5 VI 37 PR American Samoa 0 FS of Micronesia 0 Guam 5 Marshall Islands 0 Palau 0 *October 2007 to present 8406

17. VALUE ● INTEGRITY ● ACCESS Types of Inquiries to PSSC Group discussion- more interaction! – I think we qualify for 340B, do we? – I would like to learn more about becoming a 340B covered entity…where should I start? – Do you have tools we can use to determine if 340B is the best decision? – Can patients use 340B at any pharmacy?

18. VALUE ● INTEGRITY ● ACCESS Information Analysis and Management Advanced Inquiries Clinical pharmacy services – Formulary Management – Medication Therapy Management Pharmacy model selection – In house staffing – Contract pharmacy decision analysis – Telepharmacy Technology – Split billing – Automation Compliance review – Policy and procedures 340B decision analysis – Meet with stakeholders – Risk analysis 2009 Savings to entities: $4,373,927.00

19. VALUE ● INTEGRITY ● ACCESS 19 Policy Analysis OPA Federal Register Notice of Final Guidelines for Children’s Hospitals Congressional legislation to change the 340B Program HR 444 S 1239 Congressional efforts regarding Healthcare Reform HHS FY 2010 and 2011 Budget OPA Funding New PSSC Policy Products/Items Multiple Contract Pharmacy Federal Register Notice Proposal- FINAL publication Other Pharmacy Related Items both state and federal

20. VALUE ● INTEGRITY ● ACCESS Relationships and Networking ASHP – Annual and Midyear programming in coordination with Apexus/Prime Vendor Program APhA- 10 hrs of CE; 340B/Safety Net focus NRHA- Medication Use Conference Webinars- Ohio, Michigan Focus groups- Alaska Primary Care/Pharmacy Social networking:linkedin Dialogue and collaboration with many safety net stakeholder organizations NASBHC, NACHC, NCPA, NRHA, SNHPA

21. VALUE ● INTEGRITY ● ACCESS Relationships and Networking What’s new: Peer to Peer Network SNEAK PREVIEW-coming in 2011! The 340B Leading Practice Achievement Recognition 21

22. VALUE ● INTEGRITY ● ACCESS Interactive Time! As a covered entity, who has primary responsibility for carrying out the 340B program? A.Prime Vendor Program B.Pharmacy Services Support Center C.Health Resources and Services Administration-Health Systems Bureau D.Office of Pharmacy Affairs E.All of the Above 22

23. VALUE ● INTEGRITY ● ACCESS Interactive Time-small groups How will you apply 340B to your practice setting? How can we utilize meetings/forums like NRHA to engage stakeholders? What action item will you take when you get back to implement or optimize 340B? 23

24. INTEGRITY ● ACCESS ● VALUE 24 Contacts: www.hrsa.gov/opa www.hrsa.gov/patientsafety pssc.aphanet.org pssc@aphanet.org 1-800-628-6297 www.340bpvp.com 340B_primevendor@340bpvp.com 1-888-340-2787 Pharmacy Services Support Center Prime Vendor Program

25. INTEGRITY ● ACCESS ● VALUE 25 Thank You! PSSC@aphanet.orgPSSC@aphanet.org 1-800-628-6297