Problem Statement

The federal 340B Drug Pricing Program lets eligible hospitals buy outpatient drugs at steep discounts, and the resulting savings fund care for underserved patients, making it a meaningful source of margin that hospitals depend on. Keeping that benefit requires staying compliant: only prescriptions tied to qualifying patients, encounters, and authorized providers are 340B-eligible, and hospitals must audit eligibility, report any material breach to HRSA, and recertify annually. For Specialty Pharmacy, each prescription has to be checked against qualification criteria, matched to the right patient and prescription in Epic Willow Ambulatory, verified against completed-visit and department information, and then flagged as qualified or not. This is detailed per-prescription work, and a wrong flag either forfeits eligible savings or claims a discount the prescription didn't earn.

Automation Solution

This automation audits Specialty Pharmacy 340B-eligible prescriptions in Epic Willow Ambulatory and applies the appropriate 340B qualification flag based on report results.