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On October 1, 2021, the Medication Cost Transparency Act (Senate Bill 257-Session Law 2021-161, the “Act”) went into effect. In addition to establishing state oversight and licensure of Pharmacy Benefit Managers (PBMs), the Act also creates new protections for federally qualified health centers (FQHCs), FQHC look-alikes, and other covered entities under the 340B Drug Discount Program. In general, the law prohibits many PBMs from discriminating against covered entities’ 340B in-house pharmacies and contract pharmacies through differential reimbursement, chargebacks, fees, adjustments, and network access. This memo provides an overview of the 340B provisions (N.C.G.S. § 58-56A-50) of the Act.

Click link to download:
NCCHCA Memo – What FQHCs Need to Know About New State 340B Protections – DEC 2021

What do I do if I think being discriminated against?

  1. Notify the North Carolina Community Health Center Association (NCCHCA) by calling, emailing, or filling out the form at the bottom of this page.
  2. Attempt to resolve the complaint directly with the PBM or insurer.
    Keep copies of all communications and evidence of suspected 340B discrimination by the PBM.
  3. File a complaint with the Department of Insurance.
    In addition to notifying the NCCHCA, FQHCs and other covered entities under the Act who suspect discriminatory treatment by PBMs are encouraged to file a complaint through the North Carolina Department of Insurance against the PBM and underlying health plan.

    1. Call the Consumer Services Division at 855-408-1212 prior to submitting a written complaint.
    2. File a complaint using either the online complaint form or downloading and mailing a paper complaint form.

340B

Notify NCCHCA of unfair treatment of your CHC's 340B Pharmacy program.

Health Insurance for Children

Speak with someone about health insurance for you and your child.  Hablar con alguien sobre las opciones de seguro médico para usted o su hijo,

 

 

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