Updates from your ACE team
This newsletter we're bringing you valuable 340B pharmacy information, coronavirus (COVID-19) updates and the latest NACHC stats from the 2020 Chartbook!

How are you treating your patients with Coronavirus (COVID-19) symptoms? Telehealth is an excellent billable option for remote or traveling physicians that also keeps them away from the infected patient(s). The government is prepared for providers to start treating COVID-19 with telehealth. Are you ready? Click HERE for the new COVID-19 telehealth codes. This information may change as this national emergency progresses.
HHS has a budget to reduce healthcare costs
Who isn't trying to improve healthcare costs? It seems as if it's been on the center stage for conversation for years. Xtelligent Healthcare Media recently hosted a podcast for healthcare professionals seeking solutions for today's and tomorrow's top challenges that pave the way for tangible improvements in care quality, outcomes and cost.

The goal of the U.S. Department of Health and Human Services (HHS) is to "enhance and protect the health and well-being of all Americans by providing for effective health and human services and by fostering sound, sustained advances in the sciences underlying medicine, public health and social services." HHS has been proactive in putting America's health first. The department's " proposed budget of $94.5 billion in discretionary budget authority and $1.3 trillion in mandatory funding for HHS reflects HHS' commitment to making the federal government more efficient and effective by spending in areas with the highest impact. "
As COVID-19 continues to sweep across the nation, community health centers are becoming worried about the surge of patients expected to walk through their doors. Community health centers are running out of personal protective equipment (PPE), which is only increasing the fears of having to close if staff members are exposed, become sick and are quarantined.

Ronald Yee, Chief Medical Officer for the National Association of Community Health Centers, is urging Congress to reauthorize funding for the Community Health Center Fund program, which makes up 70 percent of the federal support community health centers receive. With funding expiring on May 22, 2020, " Yee said nearly 1,400 community health centers and their 12,000 sites would be left without resources to provide COVID-19 testing to the most economically vulnerable individuals. "

NACHC is urging the communities to connect with Congress to extend the funding past May 22.

HRSA is aware that community health centers are experiencing budget challenges because of COVID-19 . As a result, "health centers may draw grant funding from Payment Management Systems (PMS) for expenses in alignment with health center's financial and operational policies and procedures and the approved grant budget." HRSA is encouraging community health centers to "consider the pace of their spending to ensure sufficient funds to avoid any funding" shortcomings.

The Coronavirus Preparedness and Response Supplemental Appropriations, that passed March 6, 2020, allows providers to bill " Medicare fee-for-service for patient care delivered by telehealth for the duration of COVID-19 ." In the government's latest efforts to fight COVID-19 it released $8.3 billion for an emergency COVID-19 package. $100 million of that total is available to HRSA for FQHCs to prevent, prepare for a respond to the national emergency of COVID-19 .

Effective March 17, 2020, "the Trump administration announced further expansion of telehealth coverage for Medicare beneficiaries. CMS hopes this effort of including telehealth in its billable services will help contain the spread of COVID-19 . [Additionally] many insurance issuers announced they are also expanding efforts by waiving copays and prior authorizations, covering the cost of COVID-19 test[ing] and allowing reimbursement for telehealth."

Do you know the new ICD-10-CM codes the Center for Disease Control and Prevention (CDC) released that will go into effect on April 1, 2020? Click here for the new codes .

We'll continue to keep you updated as this develops. In the meantime, have you considered treating patients with COVID-19 symptoms through telehealth?
Community health centers are important!
NACHC released its 2020 chartbook, Community Health Center Chartbook , that details the overall importance of community health centers and the impact they have on the communities they serve.

Together, health centers serve 1 in 12 people in the United States, including:
  • 1 in 9 children
  • 1 in 7 racial/ethnic minorities
  • 1 in 5 Medicaid beneficiaries
  • 1 in 5 uninsured persons
  • 1 in 3 people in poverty
Let's talk big numbers for who the people included in the above stats are:
  • 385,222 are veterans
  • 1,413,256 are experiencing homelessness
  • 4,415,160 live in public housing
  • 6,706,410 are served in a language other than English
  • 995,232 are agricultural workers
  • 819,177 are school-based
Additionally, health center patients suffer from chronic conditions at higher rates than the general population. Hypertension is the most common chronic illness at 45 percent. When comparing health centers and the country's population, 42 percent - compared to the US' population at 18 percent - have health that is either fair or poor.
From 2013 to 2017, the percent of patients with chronic diseases has increased by 25 percent. Patients with the following diseases have increased by:
  • Overweight/obesity - 146 percent
  • Chronic Obstructive Pulmonary Disease (COPD) - 143 percent
  • Substance use disorders (not including tobacco and alcohol use) - 73 percent
  • HIV - 44 percent
  • Depression - 39 percent
How are you treating these patients and where are they getting their prescriptions filled? These are the patients that can transform your facility to be financially independent through 340B pharmacy.
340B today and in the future
Drug Channels' latest blog post, Drug Channels News Roundup, February 2020: Amazon Care, Generics in Part D, Rebates vs List Prices, Walmart Health, and Cheetos , touches on the fact that the majority (53 percent) of generic drugs are non-generic tiers in Part D. For example, Medicare Part D plans have rejected the therapeutically identical but lower-priced versions of the drugs that treat hepatitis C. The only people benefiting from Medicare Part D plans (are the plans) and seniors who don't need specialty medications.

Are you protecting the seniors that come through by assisting them with their 340B options?
The 340B program has been evolving for the past 10 years and continues to do so.

The 340B Coalition Winter Conference entertained conversations of how to utilize the program to tackle some of our country's largest issues, including addressing health care access, affordability challenges and how the 340B program can end the HIV/AIDS epidemic by 2030.
HRSA's coming!
In our January newsletter , we touched on a 340B audit that resulted in HRSA and Xspire concluding that Xspire didn't offer the proper cap on the 340B prescriptions sold from 8/1/2012-8/1/2019.

Would you be prepared for HRSA to audit your pharmacy?

The word "audit" often causes hysteria, and one by the government body HRSA surely doesn't help the situation; but it doesn't have to. Our 340B HRSA audit plan and tool kit details how to create a smooth streamlined process for handling HRSA's audits.

To create an environment for a smooth HRSA audit, we recommend:
  1. monthly self-audits of at least 30 random pharmacy claims to monitor for diversion, duplicate discounts and auditable records.
  2. Annual self-audits to review accuracy of HRSA database records including eligibility documents, registered child sites and contract pharmacies, contact personnel and addresses.
  3. Annual independent external audits following the HRSA audit structure to gain an objective opinion of the overall compliance of your program.
Media watch and other useful info
As COVID-19 continues to spread across the world, the United States' medical community is responding by canceling several different events. See if your event is canceled HERE .

As community health centers across the country continue to be the front lines for treating COVID-19, NACHC urges the communities to connect with Congress to extend the funding past May 22, 2020.

NACHC is following COVID-19. Stay updated with their COVID-19 information for community health centers here .

Have you been keeping up with all of HRSA's 2020 340B updates? Get them all here!

Stay up to date with HRSA's latest information about COVID-19 here .