Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 355 - REIMBURSEMENT RATES
Subchapter J - PURCHASED HEALTH SERVICES
Division 28 - PHARMACY SERVICES: REIMBURSEMENT
Section 355.8548 - 340B Covered Entities

Universal Citation: 1 TX Admin Code ยง 355.8548

Current through Reg. 49, No. 38; September 20, 2024

(a) Scope. This section applies to each manufacturer of outpatient drugs that has executed an agreement with the Secretary of the United States Department of Health and Human Services under Section 340B of the Public Health Service Act (RSA 256b).

(b) Definitions. For purposes of this section, the following terms are defined as follows:

(1) 340B covered entity--A health-care organization enrolled in the 340B Program.

(2) 340B covered outpatient drug--A drug eligible for purchase through the 340B Program, as defined in 42 C.F.R. § 10.20 and § 10.21.

(3) 340B price--The maximum price that the United States Health Resources and Services Administration will allow a drug manufacturer to charge a 340B covered entity for a 340B covered outpatient drug purchased through the 340B program. The 340B price is also known as the "ceiling price."

(4) 340B program--A drug-pricing program established under Section 340B of the Public Health Service Act (RSA 256b) under which a manufacturer of covered outpatient drugs agrees that it will not charge a 340B covered entity more than the 340B price for a 340B covered outpatient drug.

(5) HHSC--The Texas Health and Human Services Commission or its designee.

(c) Reimbursement methodology. HHSC reimburses a 340B covered entity for a 340B covered outpatient drug purchased through the 340B program and dispensed to a patient of a 340B covered entity based on HHSC's estimate of the 340B price plus a professional dispensing fee assigned by HHSC in accordance with §355.8551 of this division (relating to Professional Dispensing Fee).

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