FQHCs and pharmacies press for clearinghouse model to replace 340B claim modifiers; pharma voices concerns

House Bill 3409 A drew a packed public hearing and sharply divided testimony Tuesday as federally qualified health centers, pharmacies and advocates asked the Senate Committee on Health Care to allow a neutral third‑party clearinghouse to determine whether a prescription qualifies for 340B discounts rather than requiring pharmacies to apply a claims modifier.

Proponents told the committee the current modifier‑based approach is administratively burdensome, causes back‑office rework and delays prescriptions at retail counters. They urged the committee to permit covered entities to use a clearinghouse that would match claims data across prescribers, pharmacies and payers so eligibility can be determined at or soon after point‑of‑sale.

Why it matters: Under the currently prevalent practices, pharmacists sometimes must reopen and resubmit claims after learning a drug was 340B‑eligible, administrative work that proponents say is time consuming and error prone. Supporters say a clearinghouse model — used for Medicaid in Oregon — would be faster, reduce…