MEMORANDUM OF UNDERSTANDING
For Participation in the 340B Drug Pricing Program
Pursuant to Section 340B of the Public Health Service Act This Memorandum of Understanding ("MOU") is entered into by and between:
San Antonio Regional Hospital, a nonprofit hospital organized under the laws of the State of California, located at 999 San Bernardino, Upland, California 91786 ("Hospital"), and
City of Fontana a unit of government organized under the laws of the State of California ("Government Agency").
The Hospital and the Government Agency may collectively be referred to as the "Parties."
1. Statutory Authority
This Memorandum of Understanding is entered into pursuant to Section 340B of the Public Health Service Act (42 U.S.C. §256b).
Under this statute, a private nonprofit hospital may qualify for participation in the 340B Drug Pricing Program if it has a contract with a unit of State or local government to provide health care services to low-income individuals who are not entitled to benefits under Medicare and who are not eligible for assistance under Medicaid.
The Parties enter into this MOU to document the Hospital's compliance with this statutory requirement.
2. Purpose
The purpose of this MOU is to formalize and document the Hospital's longstanding commitment to provide health care services to low-income, uninsured, and underserved individuals within the community, including individuals who are not entitled to Medicare or Medicaid benefits.
This agreement memorializes the Hospital's commitment to serve these populations and the Government Agency's recognition of the Hospital's role in supporting the public health of the community.
3. Background
The Parties acknowledge the following:
A. The 340B Drug Pricing Program was established by Congress to allow eligible health care providers to stretch scarce federal resources in order to serve more patients and provide more comprehensive services.
B. The Hospital is a nonprofit health care institution dedicated to improving the health of the communities it serves.
C. The Hospital has historically provided a disproportionate share of care to:
• low-income individuals
• uninsured patients
• underinsured patients
• medically underserved populations.
D. The Government Agency recognizes the Hospital's role in supporting the public health objectives of the State and the community.
4. Historical Commitment to Serve Low-Income Populations The Government Agency acknowledges that the Hospital has historically provided health care services to low-income, indigent, uninsured, and underinsured individuals residing in:
• San Bernardino County
• the State of California
• surrounding communities.
The Parties further acknowledge that this commitment existed prior to and has continued since the Hospital's participation in the 340B Drug Pricing Program beginning on January 1, 2018.
This MOU memorializes the Hospital's longstanding commitment to providing such services in the public interest.
5. Hospital Representations
The Hospital represents and warrants that:
Nonprofit Status
The Hospital is a nonprofit corporation organized and existing under the laws of the State of California and is recognized as a tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code.
Disproportionate Share Hospital Status
The Hospital receives Medicare Disproportionate Share Hospital (DSH) payments and maintains a DSH adjustment percentage that satisfies the requirements for participation in the 340B Program.
Provision of Services to Low-Income Individuals
The Hospital provides health care services to low-income individuals who are not entitled to benefits under Title XVIII (Medicare) and who are not eligible for assistance under the State plan under Title XIX (Medicaid).
Community Benefit Programs
The Hospital maintains policies and programs designed to provide access to health care for underserved populations, including but not limited to:
• charity care programs
• financial assistance policies
• community outreach initiatives
• preventive health programs
• access-to-care programs for uninsured patients.
6. Government Agency Acknowledgment
The Government Agency acknowledges and agrees that:
1. The Hospital provides essential health care services to residents of the community, including vulnerable and underserved populations.
2. The services provided by the Hospital are in the public interest and support the health and welfare of the community.
3. The Government Agency accepts the Hospital's commitment to provide health care services to low-income individuals within the community.
7. Commitment to Provide Services
The Hospital agrees that it will continue its commitment to provide health care services to low- income individuals within the community, including individuals who:
• are uninsured or underinsured
• are unable to pay for medically necessary services
• qualify for assistance under the Hospital's financial assistance policies • otherwise lack adequate access to health care.
8. Definition of Low-Income or Indigent Individuals
For purposes of this MOU, low-income or indigent individuals may include persons who:
• are uninsured or underinsured
• meet eligibility criteria under the Hospital's charity care or financial assistance policy • are otherwise unable to pay for necessary health services.
Nothing in this section limits the Hospital's ability to provide medically necessary care to any patient.
9. HRSA and 340B Program Compliance
The Hospital agrees to comply with all applicable requirements of the 340B Drug Pricing Program administered by the Health Resources and Services Administration (HRSA).
This MOU may be used by the Hospital to demonstrate compliance with eligibility requirements for participation in the 340B Program.
10. Audit Cooperation
The Parties agree to cooperate in providing documentation reasonably necessary to verify the Hospital's eligibility for participation in the 340B Drug Pricing Program in the event of a review, audit, or request by HRSA or another governmental authority.
11. Term and Effective Date
This MOU shall be deemed effective as of January 1, 2018 for purposes of documenting the Hospital's historical commitment.
This MOU shall remain in effect unless terminated by either Party upon thirty (30) days written notice.
If the Hospital becomes ineligible to participate in the 340B Program, the Hospital shall provide appropriate notice to HRSA's Office of Pharmacy Affairs.
12. Miscellaneous
Governing Law
This MOU shall be governed by the laws of the State of California.
No Agency Relationship
Nothing in this MOU shall be interpreted to create an employment, partnership, or joint venture relationship between the Parties.
Entire Agreement
This MOU represents the entire agreement between the Parties regarding the subject matter described herein.
13. Signatures
IN WITNESS WHEREOF, the Parties have executed this Memorandum of Understanding through their duly authorized representatives.
City of Fontana San Antonio Regional Hospital
Name: Acquanetta Warren
Name:
Title: Mayor Title:
Phone: (909) 350-6732 Phone:
Email: [email protected] Email:
Date:
Signature: _