Medicaid & 340B

Prescriptions may not be filled with 340B drugs and also be submitted by the state for a manufacturer rebate. This is considered a duplicate discount and is prohibited by the 340B statute. Each entity is urged to understand any state restrictions or billing requirements for use of 340B drugs for Medicaid patients.

If the entity decides to use 340B drugs for any Medicaid patients they must:

• Ensure the entity has marked Yes in the 340B HRSA database (also called Medicaid Exclusion File) for each registered site that bills Medicaid.
• Enter any NPI and Medicaid billing number used to bill 340B drugs to the state.
• Document that the entity is billing Medicaid consistent with state requirements, if appropriate.
• May not use a contract pharmacy arrangement to bill Medicaid for 340B drugs unless they have an agreement with the state and it has been reported to HRSA.