OMB control number
Enrollment and Re-Certification of Entities in the 340B Drug Pricing Program and Collection of Manufacturer Data to Verify 340B Drug Pricing Program Ceiling Price Calculations
OMB 0915-0327 · HHS/HSA.
Section 602 of Public Law 102–585, the Veterans Health Care Act of 1992, enacted section 340B of the Public Health Service (PHS) Act, which instructs HHS to enter into a Pharmaceutical Pricing Agreement (PPA) with manufacturers of covered outpatient drugs. Manufacturers are required by section 1927(a)(5)(A) of the Social Security Act to enter into agreements with the Secretary of HHS (Secretary) that comply with section 340B of the PHS Act if they participate in the Medicaid Drug Rebate Program. When a drug manufacturer signs a PPA, it is opting into the 340B Drug Pricing Program (340B Program), and it agrees to the statutory requirement that prices charged for covered outpatient drugs to covered entities will not exceed statutorily defined 340B ceiling prices. When an eligible covered entity voluntarily decides to enroll and participate in the 340B Program, it accepts responsibility for ensuring compliance with all provisions of the 340B Program, including all associated costs. Covered entities that choose to participate in the 340B Program must comply with the requirements of section 340B(a)(5) of the PHS Act. Section 340B(a)(5)(A) of the PHS Act prohibits a covered entity from accepting a discount for a drug that would also generate a Medicaid rebate. Further, section 340B(a)(5)(B) of the PHS Act prohibits a covered entity from reselling or otherwise transferring a discounted drug to a person who is not a patient of the covered entity.
The latest form for Enrollment and Re-Certification of Entities in the 340B Drug Pricing Program and Collection of Manufacturer Data to Verify 340B Drug Pricing Program Ceiling Price Calculations expires 2026-06-30 and can be found here.
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Supplementary Document |
Supporting Statement A |
| Revision of a currently approved collection | 2026-01-12 | ||
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Approved with change |
Revision of a currently approved collection | 2022-11-29 | |
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Approved without change |
Revision of a currently approved collection | 2019-08-08 | |
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Approved without change |
Revision of a currently approved collection | 2016-05-03 | |
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Approved without change |
Revision of a currently approved collection | 2015-05-01 | |
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Approved without change |
No material or nonsubstantive change to a currently approved collection | 2013-08-29 | |
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Approved without change |
No material or nonsubstantive change to a currently approved collection | 2013-07-22 | |
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Approved without change |
No material or nonsubstantive change to a currently approved collection | 2013-04-30 | |
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Approved with change |
Revision of a currently approved collection | 2012-07-24 | |
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Approved without change |
No material or nonsubstantive change to a currently approved collection | 2010-06-11 | |
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Approved without change |
Existing collection in use without an OMB Control Number | 2009-08-19 |
Hospital Enrollment, Additions and Recertifcations
Federal Enterprise Architecture: Health - Health Care Services
| Form 1.1 | 340B Registration DSH Parent.pdf | Fillable Fileable | Form |
| Form 1.9 | 340B Recertification Childrens Hospital.pdf | Fillable Fileable | Form |
| Form 1.7 | 340B Recertification DSH.pdf | Fillable Fileable | Form |
| Form 1.8 | 340B Recertification SCH and RRC.pdf | Fillable Fileable | Form |
| Form 1.11 | 340B Recertification CAN.pdf | Fillable Fileable | Form |
| Form 1.6 | 340B Registration CAH Parent.pdf | Fillable Fileable | Form |
| Form 1.3 | 340B Registration CAN Parent.pdf | Fillable Fileable | Form |
| Form 1.5 | 340B Registration RRC and SCH Parent.pdf | Fillable Fileable | Form |
| Form 1.10 | 340B Recertification CAH.pdf | Fillable Fileable | Form |
| Form 1.4 | 340B Registration Hospital Outpatient Facility.pdf | Fillable Fileable | Form |
| Form 1.2 | 340B Registration Children's Hospital.pdf | Fillable Fileable | Form |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.