| Details | State | Update | | To Be Terminated | Terminated | 4/1/2024 12:01 AM |
| Dates | Last Date That 340B Drugs Purchased | Update | Termination Request | | 1/8/2024 12:00:00 AM | 1/11/2024 12:36 PM |
| Details | State | Update | Termination Request | Active | To Be Terminated | 1/11/2024 12:36 PM |
| Terminations | Termination Comments | Update | Termination Request | | Upon completion of our 2022-2023 Medicare cost report, our applicable DSH percent was found to be 4.56%. Per HRSA regulations, our institution is separating from the 340b program. The report was filed on 12/28/23 and received by Noridian 01/03/2024. was notified of the Medicare Cost report filing 01/08/24 | 1/11/2024 12:36 PM |
| Terminations | Termination Date | Update | Termination Request | | 4/1/2024 12:00:00 AM | 1/11/2024 12:36 PM |
| Terminations | Termination Effective Date | Update | Termination Request | | 12/28/2023 12:00:00 AM | 1/11/2024 12:36 PM |
| Terminations | Termination Reason | Update | Termination Request | | DSH percentage below statutory minimum | 1/11/2024 12:36 PM |
| Details | Last Recertification Date | Update | Recertification | 9/19/2022 1:32:17 PM | 9/26/2023 7:15:12 AM | 9/26/2023 7:15 AM |
| Details | Last Recertification Date | Update | Recertification | 8/20/2021 9:38:04 AM | 9/19/2022 1:32:17 PM | 9/19/2022 1:32 PM |
| Contacts | Authorizing Official | Update | Change Request | Tate, Mary Lou
Chief Financial Officer
Campbell County Memorial Hospital
3076881523 | Shahan, Matthew
CEO
Campbell County Memorial Hospital
3076881551 | 8/29/2022 9:22 AM |
| Dates | Last Date That 340B Drugs Purchased | Update | COVID-19 Reinstatement | 1/31/2022 12:00:00 AM | | 4/6/2022 7:47 PM |
| Details | State | Update | COVID-19 Reinstatement | Terminated | Active | 4/6/2022 7:47 PM |
| Dates | Start Date | Update | COVID-19 Reinstatement | 7/1/2016 12:00:00 AM | 3/15/2022 12:00:00 AM | 4/6/2022 7:47 PM |
| Terminations | Termination Comments | Update | COVID-19 Reinstatement | Campbell County health fell below the 8% DSH Ratio when we filed our 2021 Cost report. While we thought we notified everyone, we overlooked requesting a status change on this website. We did stop purchasing drugs under our 340b account as of 01/31/22, we learned today that 340b Direct is processing 2 contract pharmacy claims. We have filed an exemption under the Appropriations act to reinstate our 340b status. | | 4/6/2022 7:47 PM |
| Terminations | Termination Date | Update | COVID-19 Reinstatement | 4/1/2022 12:00:00 AM | | 4/6/2022 7:47 PM |
| Terminations | Termination Effective Date | Update | COVID-19 Reinstatement | 2/1/2022 12:00:00 AM | | 4/6/2022 7:47 PM |
| Terminations | Termination Reason | Update | COVID-19 Reinstatement | DSH percentage below statutory minimum | | 4/6/2022 7:47 PM |
| Details | State | Update | | To Be Terminated | Terminated | 4/1/2022 12:01 AM |
| Dates | Last Date That 340B Drugs Purchased | Update | Termination Request | | 1/31/2022 12:00:00 AM | 3/30/2022 7:17 AM |
| Details | State | Update | Termination Request | Active | To Be Terminated | 3/30/2022 7:17 AM |
| Terminations | Termination Comments | Update | Termination Request | | Campbell County health fell below the 8% DSH Ratio when we filed our 2021 Cost report. While we thought we notified everyone, we overlooked requesting a status change on this website. We did stop purchasing drugs under our 340b account as of 01/31/22, we learned today that 340b Direct is processing 2 contract pharmacy claims. We have filed an exemption under the Appropriations act to reinstate our 340b status. | 3/30/2022 7:17 AM |
| Terminations | Termination Date | Update | Termination Request | | 4/1/2022 12:00:00 AM | 3/30/2022 7:17 AM |
| Terminations | Termination Effective Date | Update | Termination Request | | 2/1/2022 12:00:00 AM | 3/30/2022 7:17 AM |
| Terminations | Termination Reason | Update | Termination Request | | DSH percentage below statutory minimum | 3/30/2022 7:17 AM |
| Contacts | Primary Contact | Update | Change Request | Quintana, Robert
Director of Pharmacy
Campbell County Memorial Hospital
3076883271 | Ludwig, Kirsi Maria
Pharmacy Director
Campbell County Health
3076883271 | 8/30/2021 8:35 AM |
| Details | Last Recertification Date | Update | Recertification | 8/19/2020 10:44:29 AM | 8/20/2021 9:38:04 AM | 8/20/2021 9:38 AM |
| Details | Last Recertification Date | Update | Recertification | 9/8/2019 10:05:18 AM | 8/19/2020 10:44:29 AM | 8/19/2020 10:44 AM |
| Contacts | Authorizing Official | Update | Change Request | HEETER, COLLEEN
Chief Operating Officer
Campbell County Hospital District
3076881551 | Tate, Mary Lou
Chief Financial Officer
Campbell County Memorial Hospital
3076881523 | 1/31/2020 8:34 AM |
| Details | Last Recertification Date | Update | Recertification | 8/23/2018 7:03:13 AM | 9/8/2019 10:05:18 AM | 9/8/2019 10:05 AM |
| Contacts | Authorizing Official | Update | Change Request | Huber, Dalton
Chief Financial Officer
Campbell County Hospital Disctrict
3076881523 | HEETER, COLLEEN
Chief Operating Officer
Campbell County Hospital District
3076881551 | 4/18/2019 12:30 PM |
| Details | Last Recertification Date | Update | Recertification | 11/8/2017 8:53:43 AM | 8/23/2018 7:03:13 AM | 8/23/2018 7:03 AM |
| Contacts | Primary Contact | Update | Recertification | Huber, Dalton
Chief Financial Officer
3076881523 | Quintana, Robert
Director of Pharmacy
Campbell County Memorial Hospital
3076883271 | 11/8/2017 8:53 AM |
| Details | Last Recertification Date | Update | Recertification | 8/10/2016 12:00:00 AM | 11/8/2017 8:53:43 AM | 11/8/2017 8:53 AM |
| Contacts | Authorizing Official | Update | | Huber, Dalton
Chief Financial Officer
3076881523 | Huber, Dalton
Chief Financial Officer
Campbell County Hospital Disctrict
3076881523 | 10/26/2017 12:42 PM |
| Contacts | Signed By | Update | | Huber, Dalton
Chief Financial Officer
3076881523 | Huber, Dalton
Chief Financial Officer
Campbell County Hospital Disctrict
3076881523 | 10/26/2017 12:42 PM |
| Addresses | Main Address | Insert | | |
501 S BURMA AVENUE
GILLETTE, WY 82717-3011 | 3/1/2017 11:26 AM |
| Contacts | Authorizing Official | Insert | | | Huber, Dalton
Chief Financial Officer
3076881523 | 3/1/2017 11:26 AM |
| Contacts | Primary Contact | Insert | | | Huber, Dalton
Chief Financial Officer
3076881523 | 3/1/2017 11:26 AM |
| Contacts | Signed By | Insert | | | Huber, Dalton
Chief Financial Officer
3076881523 | 3/1/2017 11:26 AM |
| Details | Last Recertification Date | Update | | | 8/10/2016 12:00:00 AM | 8/10/2016 11:24 AM |
| Dates | Participating Approval Date | Update | | | 5/9/2016 12:00:00 AM | 5/9/2016 9:41 AM |
| Details | State | Update | | Pending | Active | 5/9/2016 9:41 AM |
| Dates | Start Date | Update | | | 7/1/2016 12:00:00 AM | 5/9/2016 9:41 AM |
| Details | 340B ID | Update | | ONLINE_REG_59059 | SCH530002-00 | 5/3/2016 9:40 AM |
| Details | 340B ID | Update | | | ONLINE_REG_59059 | 4/5/2016 5:46 PM |
| Details | Last Recertification Date | Insert | | | | 4/5/2016 5:46 PM |
| Details | Grant Number | Insert | | | | 4/5/2016 5:46 PM |
| Details | 340B ID | Insert | | | | 4/5/2016 5:46 PM |
| Details | Is Authorizing Official EHB Data | Insert | | | | 4/5/2016 5:46 PM |
| Dates | Last Date That 340B Drugs Purchased | Insert | | | | 4/5/2016 5:46 PM |
| Details | Medicare Provider Number | Insert | | | 530002 | 4/5/2016 5:46 PM |
| Details | Entity Name | Insert | | | CAMPBELL COUNTY MEMORIAL HOSPITAL | 4/5/2016 5:46 PM |
| Details | Program Code | Insert | | | SCH | 4/5/2016 5:46 PM |
| Details | Entity Subname | Insert | | | | 4/5/2016 5:46 PM |
| Dates | Participating Approval Date | Insert | | | | 4/5/2016 5:46 PM |
| Details | State | Insert | | | Pending | 4/5/2016 5:46 PM |
| Dates | Registration Date | Insert | | | 4/5/2016 12:00:00 AM | 4/5/2016 5:46 PM |
| Dates | Signed By Date | Insert | | | 4/5/2016 12:00:00 AM | 4/5/2016 5:46 PM |
| Dates | Start Date | Insert | | | | 4/5/2016 5:46 PM |
| Terminations | Termination Comments | Insert | | | | 4/5/2016 5:46 PM |
| Terminations | Termination Date | Insert | | | | 4/5/2016 5:46 PM |
| Terminations | Termination Effective Date | Insert | | | | 4/5/2016 5:46 PM |
| Terminations | Termination Reason | Insert | | | | 4/5/2016 5:46 PM |