Reference answer · 340b-program · reviewed quarterly
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Review cadence: quarterlyUnderlying federal data: refreshed weekly to annual per source
Q&A library · 340b-program

How does HRSA determine if someone is a 340B patient for claims?

HRSA does not decide 340B patient status from the claim alone. The key test is whether the covered entity has an established responsibility for the individual's care and whether the prescription is tied to care documented in the entity's records; contract pharmacy use, prescriber status, or claim routing by themselves do not prove eligibility.