Medicare Designated Provider-Based Clinics and Departments – 2-Part Series

The Medicare provider-based service designation allows hospitals, physician practices, and other care centers, including Critical Access Hospitals, to obtain higher Medicare and Medicaid reimbursements and participate in the 340B Drug Pricing Program. Costs of pharmaceutical purchases are significant and operating a robust contract pharmacy program under the 340B allows for additional revenues stream for non-for-profit systems.

The provider-based designation regulations are complex, challenging to implement and maintain compliance, however. CMS has challenged and recently increased scrutiny over some provider-based designated determinations. This course will offer comprehensive understanding of designation compliance, existing provider-based regulatory requirements, complex operational issues, and reimbursement benefits.