No matter the size or sophistication of the 340B program — from rural clinics to multi-site health systems — the same issues keep showing up. And while most aren’t outright violations (yet), they carry the kind of operational risk that can lead to missed savings, HRSA findings, or pricing pushback from manufacturers.

At RxTrail, our team recently completed a series of deep-dive audits across 100+ different 340B programs. What we found? It’s not always the big, obvious problems that cause the most damage — it’s the small gaps that go unchecked for months.

What We Found (and Why It Matters)

Without giving away the full list, here’s a preview of what made the top of our findings:

• Prescriptions tied to ineligible locations — often hidden in provider schedules, rotations, or unaffiliated clinics
• Undocumented or informal prescriptions — the kind that quietly undermine compliance if not addressed directly
• Medicaid billing inconsistencies — usually tied to carve-in logic or MEF issues that no one flagged until the audit

These are preventable problems — but only if you know where to look.

Your Audit Workbook Is Here

We’ve compiled the top three issues from these audits — including how to spot them and what to do next — in a practical, premium resource:

Inside, you’ll get:

• The exact red flags we look for during program reviews
• Specific EMR and billing clues that suggest an issue is brewing
• Practical fixes your team can implement now — before it turns into a finding

Whether you're preparing for a formal audit, evaluating risk, or simply tightening up your program, this guide will help you get aligned, compliant, and confident.

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Need support reviewing your prescriber logic, MEF setup, or contract pharmacy relationships?
Let’s schedule a quick discovery call — we’ll show you how we help covered entities close gaps before they become costly.

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