Definition
of a Patient
The Office of
Pharmacy Affairs has published final
notice of guidelines on definition of a patient
to allow a clearer understanding of which
individuals may receive prescribed medications
purchased at the legislatively mandated discount
of Section 602 of
the Veterans Healthcare
Act of 1992.
In summary,
an individual is a "patient" of a covered
entity (with the exception of State-operated
or funded AIDS drug purchasing assistance
programs) only if:
- the covered
entity has established a relationship
with the individual, such that the
covered entity maintains records of
the individual's health care; and
- the
individual receives health care
services from a health care professional
who is either employed by the covered
entity or provides health care
under contractual or other arrangements
(e.g. referral for consultation)
such that responsibility for the
care provided remains with the
covered entity; and
- the
individual receives a health care
service or range of services from
the covered entity which is consistent
with the service or range of services
for which grant funding or Federally-qualified
health center look-alike status
has been provided to the entity.
Disproportionate share hospitals
are exempt from this requirement.
An individual
will not be considered a "patient" of the
entity for purposes of 340B if the only health
care service received by the individual from
the covered entity is the dispensing of a
drug or drugs for subsequent self- administration
or administration in the home setting.
An individual
registered in a State operated AIDS drug
purchasing assistance program receiving
financial assistance under title XXVI
of the PHS Act will be considered a "patient" of
the covered entity for purposes of this
definition if so registered as eligible
by the State program.
For more information,
please refer to the October 1996 Final
Notice Regarding Section 602 of the Veterans
Health Care Act of 1992 Patient
and Entity Eligibility.
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