Customer Story: How MUSC Safeguards Critical 340B Program Eligibility with a 100% Audit of >3M Pharmacy Claims

Introduction

The Medical University of South Carolina (MUSC) is a top-ranked academic medical center based in Charleston, South Carolina. With over 2,700 beds across 16 hospitals and nearly 34,000 employees, MUSC is a recognized research and patient care leader. U.S. News & World Report has ranked MUSC as the #1 hospital in South Carolina for 11 consecutive years.

As an organization with an $8.2 billion total enterprise operating budget, MUSC manages complex operations at scale, including a robust 340B program spanning five eligible Disproportionate Share Hospitals (DSH), allowing them to treat a large and diverse patient population.

‍

Challenge: Managing 340B Program Complexity and Risk

The 340B Drug Pricing Program enables eligible healthcare organizations to purchase outpatient medications at significantly reduced prices, allowing them to stretch resources and reinvest savings into patient care for underserved populations. For safety-net hospitals like the MUSC, 340B savings are essential to sustaining critical services and expanding access. However, the complexity and volume of claims required to maintain compliance can pose significant operational challenges, especially as programs grow in scale.

As MUSC’s 340B program expanded to over 350,000 claims per month, their lean three-person team worked to build and maintain a strong compliance process. But as claim volume surged, even their well-established workflows couldn't keep pace. The team spent most of their time on labor-intensive audits, which limited their ability to explore broader opportunities and strategic initiatives across the program.

John David Scheper, System Director of 340B Program Operations, described the challenge as "looking for a needle in a haystack"; a small subset of issues amongst their millions of annual claims could easily expose the system to compliance risk. MUSC prioritized finding a solution that would protect and preserve its 340B covered entity status and the critical savings tied to it. These savings directly support access to care for underserved patients and help to sustain vital clinical programs.

Beyond the inefficiencies of manually auditing such a huge volume of claims, team member transitions created knowledge gaps, further jeopardizing program compliance posture and increasing audit vulnerability. The MUSC team needed a solution to maintain integrity, improve claim review accuracy, and reduce reliance on outdated manual processes.

‍

Solution: 100% Audit Coverage for 340B Claims

MUSC leverages the Plenful platform to automate their 340B compliance audits. Plenful’s initial scope covered an important subset of MUSC’s claims, specifically those from contract and in-house pharmacies. Subsequent to implementation, auditors went from spotting just a few issues per month to confidently addressing dozens. Convinced by the efficiency gains, MUSC quickly expanded the audit to include all mixed-use claims, expanding the coverage of Plenful’s platform to 100% of their 340B claims. 

Plenful integrates seamlessly with MUSC's data ecosystem, ingesting and normalizing data from Epic, MacroHelix, Walgreens, Wellpartner, and Verity. The platform also uses a Plenful-hosted SFTP for daily and monthly data exchanges, requiring minimal IT effort from MUSC’s technical team.

Once data lives in Plenful, our workflow automation platform runs a continuous, 100% audit of all 340B claims, flagging claims that need the team’s attention in our user-friendly task management queue.

No more searching for a needle in a haystack, with Plenful, they're using a magnet.

‍

Results: Protecting MUSC’s 340B Program and Lowering Their HRSA Risk Score

Key Results:

To date, the Plenful partnership has unlocked real value for the MUSC team:

• 100% compliance audit of >3 million 340B claims, scaling auditor capacity
• Expanded to full audit coverage in under one week, including mixed-use claims, a testament to Plenful's flexibility and impact
• Achieved >4.5x ROI by amplifying auditor productivity and strengthening compliance posture
• Enabled real-time audit performance tracking and cross-departmental alignment through executive dashboards

Since going live in January 2025, Plenful has audited more than 3 million claims for MUSC. Plenful’s intuitive task management dashboard makes it easy for MUSC’s team to review and reconcile flagged claims as they surface. This 100% claim audit would be virtually impossible to replicate manually. MUSC estimates it would take over a hundred team members to match the coverage and precision of Plenful’s automation. Plenful unlocks significant capacity gains for their lean team.

Plenful's analytics capabilities have also strengthened MUSC's preparedness for HRSA audits. Plenful comprehensively audits claims previously approved by other systems and flags those missing sufficient eligibility justification, alerting MUSC's team to take targeted corrective action exactly where they can make the biggest impact.

Plenful’s ability to ingest and normalize data is also helping MUSC’s team work cross-functionally with other business units, a common challenge at large academic medical centers with multiple care facilities. With transparent dashboards, the MUSC team can surface inconsistencies between departments that traditionally operate in silos. The platform has become a vital part of their compliance culture, working to protect their critical 340B program. 

Increased reporting visibility helps MUSC feel more in control of their 340B program results and impact.

The value the team is receiving expands beyond ROI to reduced levels of stress and uncertainty about the strength of their 340B compliance posture.

‍

Looking ahead

MUSC's experience affirms that automation can transform compliance from a source of anxiety into a point of pride. With Plenful, they’re not just searching for potential audit risks; they’re proactively managing them with confidence and clarity. Together, MUSC is safeguarding its 340B program and is properly equipped for continued growth.

‍

Ready to Learn More?

If you’d like to learn about the solutions we’re building at Plenful, book an introductory call. We’ll share how Plenful’s agentic operating system is helping 340B teams automate audits, capture millions of dollars in missed savings, and transform insitutional knowledge into scalable infrastructure.

We'd love to stay connected. Follow Plenful on LinkedIn for continued best practices and opportunities to prepare your 340B team for the 340B rebate model pilot and other upcoming changes.