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April 28, 2025 14 mins

The ancillary outpatient sites known as 340B child sites serve as important places for patients to access the drugs and care they need. There are crucial steps involved in effectively onboarding potential child sites as well as ongoing processes involved with maintaining the parent hospital’s partnership with those sites. University Hospitals Cleveland Medical Center  340B Pharmacy Manager Joe Moss joins us to shed light on this process and the potential problems to be on the lookout for.


How is a 340B child site onboarded?


Moss says the first big step to identifying potential sites is to work with a hospital’s finance, revenue, pharmacy, and legal departments to evaluate a site. The team looks at Medicare cost reports and trial balances to ensure they are eligible for 340B. As part of the process, they also use electronic medical record and retail data to identify potential clinic areas based on their patient volumes.


A 340B child site is registered. Now what?

The work is not over once a child site has been registered in 340B. UH has a program it calls the “340B Concierge Program,” which aims to provide comprehensive, ongoing support and guidance to a given child site. The program offers additional education and information in such areas as procurement processes, the appropriate ways to handle drug transfers, and miscellaneous licensing issues.


Onboarding requires relationships and a close eye on compliance


Moss says that hospitals onboarding a child site should establish and maintain close ties with the site to prevent issues with 340B compliance. This can involve being the first line for any pharmacy issues the site staff might be having, holding frank conversations with clinic management when necessary, and inviting staff to observe mock audits so they can learn more about what goes into maintaining 340B compliance.


Resources:

  1. Trump Executive Order Could Revive Medicare 340B Cuts
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