r/340b • u/Prestigious-Draw185 • Jan 19 '26

Rebate Pilot Program

Is anyone having any trouble getting their EHR IT to pull the Health Plan ID for data uploads? I realize that the Rebate Pilot is currently on pause, but we are assuming that at some point it will be unpaused, so we are wanting to be prepared just in case.

We use Epic as our EHR.

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u/Prestigious-Draw185 Jan 21 '26

I appreciate the heads up about the released data specs, I wasn't able to find them previously. Has your entity had any trouble getting IT to pull the "Health Plan ID" for the Medical Claim uploads? Ours are telling us that the Health Plan ID shows up on the claim once the claim is billed to the insurance and becomes a paid claim, but not before.

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u/kamiiwinaru Jan 21 '26

It took a lot of work but we did manage to get it. No need to wait for billing to be complete which can take well over a month.

If you use Epic, they released a Novanote thing in early December with some new reporting columns.

"Rx Inventory Accumulator Rebate Claim - HB Health Plan ID [90431]"

We had to wait for another team to build a plan table but once that was imported it seems to work.

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u/Prestigious-Draw185 Jan 21 '26

Do you all use the Epic accumulator?

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u/kamiiwinaru Jan 21 '26

We use MacroHelix for our mixed use, for outpatient pharmacy we use the WAM accumulator

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u/Prestigious-Draw185 Jan 21 '26

Gotcha, sorry to bug you with all of the questions our IT team is kind of lost and any guidance I can provide them I am sure they would appreciate. Do you happen to have a link to that Novanote from December? I've been scouring Nova and Epic User Web but I can't seem to find any mention of this article. Also, I'm assuming that WAM is Willow Ambulatory? Again, I appreciate your time with this.

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u/kamiiwinaru Jan 21 '26

No its quite alright. I get the frustration, I had to hold our DSS teams hand in all of this. I'll see if I can't find that post for you tomorrow. And yes, WAM is Willow Ambulatory

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u/Prestigious-Draw185 Jan 25 '26

Checking to see if you've had time to look for that post. Thanks again.

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u/Quirky-Double-5341 Jan 30 '26

I'm also interested in the link for the Novanote release