| Admin Setup

Multi-CE refers to a setup process where a contract pharmacy (CP) is contracted with multiple covered entities (CE). A separate retail pharmacy ID (PID) is set up to represent each CP-CE relationship. When 340B Architect receives the switch data from the CP, the system will test the data to determine which PID the prescription will be assigned to and test for 340B eligibility. 340B eligibility testing may be setup differently for each CP-CE relationship based on an existing PSA or the CE’s interpretation of the 340B Program, etc.

How It Works

Here is an example of what Multi-CE looks like:

• PID 123 represents the CP and CE 1 relationship.
• PID 456 represents the CP and CE 2 relationship (enrolled in Macro Helix’s Community Prescription Assistance program).
• PID 789 represents the CP and CE 3 relationship.

Testing: Rx Lineage - Script Group ID (SGID)

As of March 23, 2019, when 340B Architect receives an initial prescription, the prescription will be assigned a Script Group ID (SGID) automatically. All subsequent refills of the prescription will receive the same SGID and will be assigned the same PID within the Multi-CE setup. Each fill will be independently tested for 340B qualification.

Community Prescription Assistance (CPA)

Overview

Macro Helix’s Community Prescription Assistance (CPA) allows Covered Entities (CEs) to use their 340B savings to help those patients who are most in need by passing those savings directly to patient in the form of reduced or zero-cost copays. The CE plan is assigned a unique BIN/PCN/Group number that it then provides to patients in the form of a prescription card for pharmacy claims processing. These claims are imported and tested for 340B eligibility just like all other claims.

Testing BIN / Group Check for Community Prescription Assistance-Multi CE

Each CE enrolled in the Community Prescription Assistance program receives a unique BIN/PCN/Group; any prescription we receive with that same BIN/PCN/Group will be assigned to that same PID within the Multi-CE Setup. For instance, prescriptions with a CPA BIN/Group tied to CE 2 would be assigned to PID 456 as shown in the illustration below.

Q & A

Q. Is the Script Group ID (SGID) assigned by 340B Architect or the CE?

A. The SGID is assigned by 340B Architect.

Q. Do you have an example of how an SGID works?

A. There is nothing visually to see in 340B Architect. For all Multi-CE setups, all new retail prescriptions will be given an SGID, tested and assigned to the correct PID where the patient received care. As future prescriptions are sent to 340B Architect, the system will determine if the prescription is a refill from a previous SGID or a new prescription. If it's determined the prescription is a refill from a previously received prescription, it will be assigned the same SGID as the original and will be assigned to the same PID. If it's determined that the prescription is new, it will be assigned a unique SGID and tested to determine which PID provided the patient care.