Press Releases

SAN DIEGO, SEPT. 21, 2023 — Today, SunRx, a leading healthcare technology company and 340B administrator, announced that it has acquired AuthorityRx. The acquisition complements SunRx’s current 340B offerings with the addition of auditing and enhanced compliance services as well as two cloud-based applications.

The automated Advanced Claims Capture (ACC) product supports clients by improving savings through the capture of outside referral providers, and the manufacturer support application restores and protects savings associated with recent manufacturer-imposed restrictions requiring claims uploads.

“Identifying referral claims and other missed claims due to manufacturer restrictions has in the past been a complex, often manual process, but missing these savings can hinder 340B entities’ ability to fulfill their mission,” said Mary Van Hoozer, General Manager at SunRx. “The acquisition of AuthorityRx will allow SunRx to offer an enhanced, proprietary, and compliant way to capture additional claims and provide the associated financial benefits for covered entities.”

As the industry’s leading compliance and auditing service, ACC offers an ease-of-use referral claims capture solution that can significantly increase 340B savings by uncovering and resolving fallout claims. In fact, current users of ACC have, on average, nearly doubled capture rates and revenue. ACC is Third-Party Administrator (TPA)-agnostic and can be seamlessly integrated for any covered entity, regardless of the TPA they use.

ACC’s innovative automation streamlines processes while compliantly extending eligibility to outside providers using an approach that has been validated in multiple HRSA audits. This SOC-2 certified solution also delivers a level of visibility and transparency that other programs cannot.

“For many covered entities, the 340B program is a lifeline that allows them to keep their doors open,” said Aaron Lott, PharmD, founder and president of AuthorityRx. “By combining the technology and expertise of our companies, we will give entities greater resources to serve patients and communities.”

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Media Contact

Lee Harris, Managing Principal, Sales & Strategic Relations, SunRx
lharris@sunrx.com
858.208.8785

 

About SunRx

SunRx is a healthcare technology company that assists healthcare facilities with 340B administration. Our technology helps covered entities optimize their supply chain and pharmacy operations. We provide comprehensive, auditable technology-enabled solutions, including contract pharmacy, referral capture, specialty pharmacy, advanced claims capture, and the market-leading uninsured 340B prescription discount card, with a hands-on approach to program implementation and support of compliant 340B program management. Based in San Diego, SunRx has been managing 340B programs since 2006 and provides clients industry-leading expertise and hands-on customer support. SunRX is a subsidiary of MedImpact the nation's largest independent pharmacy benefit manager (PBM) and health solutions company. Learn more at SunRx.

 

About AuthorityRx

AuthorityRx is a technology and pharmacy consulting firm. The company is made up of diverse and licensed healthcare professionals who are uniquely qualified to identify the cause of complex healthcare challenges and provide innovative solutions to resolve those challenges. Based just outside of Kansas City, AuthorityRx has brought millions of new dollars to healthcare organizations and their underserved communities across the country with our intense focus on pharmacy marketplace dynamics to include 340B auditing and compliance services, assisting with licensing retail pharmacies, accrediting specialty pharmacies, and designing custom health plan solutions for healthcare providers.

 

The contents of this page are confidential and proprietary to 340B Holdings, LLC (SunRx) and may contain material SunRx considers Trade Secrets. This document may not be reproduced, transmitted, published or disclosed to others without prior written authorization from SunRx.

Industry Insights

Since 2020, select drug manufacturers have begun deploying restrictions or limitations on the sale of their products through the 340B program. This has proven to be a marketplace disruptor that has shifted the landscape of the 340B contract pharmacy program, as covered entities have experienced a loss of savings and have had to increasingly rely on entity-owned retail and/or specialty pharmacy operations to help in their mission. The issue of manufacturer restrictions has endured several legal challenges as well with some states, such as Arkansas, Louisiana, and West Virginia, having measurable success with combating the manufacturer restrictions.

Regardless, manufacturers continue to impose restrictions with the assistance of 340B ESP, a drug industry vendor that facilitates 340B claim management and oversees implementation of drug maker policies. In many cases, the restrictions made by the manufacturers will be applied to the covered entity for all contract pharmacies unless the covered entity has created an account, made designations, and/or submitted claims within 340B ESP. Depending on the manufacturer and the type of restrictions they impose, this will restore access to either some or all of their products for one or some contract pharmacies. Each manufacturer has a policy document outlining the specific restriction(s) they are imposing and the obligations of the covered entity, as well as any exceptions, say for non-hospital covered entities. Nevertheless, covered entities will want to ensure they understand the restriction methodology and choose the most appropriate pharmacy(ies) based upon geography, drugs available to dispense at the pharmacy, and if their providers utilize the pharmacy.

For covered entities that have a 340B ESP account and have made designations while submitting claims, there are a variety of quality assurance exercises to complete that will ensure 340B ESP is facilitating the manufacturer restrictions appropriately.

On a monthly basis, covered entities should log into ESP and review all designations that have been made with each manufacturer to ensure they are still designated and are aligned with the covered entity’s designation strategy. The covered entity should download the eligibility file and ensure it matches each manufacturer that the covered entity clicks into. Any discrepancies identified should be addressed immediately with 340B ESP. Upon completion, send the eligibility file to your Third-Party Administrator and Wholesaler partners for additional review.

Third Party Administrator and Wholesaler Review

Upon completion of the designation review and ensuring the 340B ESP system is demonstrating the correct information, the covered entity will want to communicate with their third-party administrator(s) and wholesaler(s) to ensure they understand the pharmacies that have been designated for use. These partners will need to make sure any pharmacy or drug “blocks” are appropriately implemented or removed to facilitate 340B pricing. On a monthly basis, these partners will want to share what their current blocks are pertaining to 340B ESP and the manufacturer restrictions to ensure alignment.

Manufacturer Policy Changes and 340B ESP Updates

Any time a manufacturer releases a policy update, or a new manufacturer decides to impose restrictions, the covered entity will want to immediately log into 340B ESP and complete the Designation Review. A new designation may be required, or a designation may warrant an adjustment to ensure optimal savings occur. In rare instances, 340B ESP may make enhancements or communicate downtimes within their system. If the covered entity receives a communication from 340B ESP about this, the covered entity will want to log into 340B ESP and complete the Designation Review to ensure no designations were adjusted as a result.

Regular monitoring of the 340B ESP system is critical to minimizing losses of savings with the 340B contract pharmacy program. 

Questions? Contact Justin Ott, MHA at jott@sunrx.com

The content in this blog is for informational purposes only and is not intended to be used in place of regulatory guidance. The opinions and views expressed herein are those of the authors and do not necessarily reflect the official position or opinions of SUNRx or any regulatory authority. Furthermore, some content may contain copyrighted material, the use of which has not always been specifically authorized by the copyright owner, but which we believe constitutes a "fair use" of any such copyrighted material as provided for in Section 107 of the US Copyright Law. We are making the information herein available in our efforts to advance understanding of the 340B program and its offerings. These views are always subject to change, revision, and rethinking at any time and may not be held in perpetuity.