340B State Medicaid

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Medicaid Profiles Per State/Territory

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In order to support 340B transparency and compliance, Prime Vendor Program staff has researched state Medicaid requirements, and provides this as a free tool for stakeholders. There are both federal and state 340B-specific Medicaid requirements for covered entities, and this resource focuses on making state requirements accessible. This resource also combines the most recently available state data with publicly available federal data. Additional requirements or contractual obligations may be in place from third party payers, but that is out of scope for this website. For more information on federal requirements, visit the HRSA website. For questions regarding information presented on this page, or to report an inaccuracy, please contact us via email, or through Apexus Answers.

Below is a table of current Medicaid CARVE-IN percentages. The table is rolled up to show all entity types, but can be expanded to show further breakdowns. Selecting a State/Territory from the drop down menu will filter data to show only that of the selected state. Additionally, two more tables will be displayed, State Medicaid Details and State Medicaid Contacts.

Please note: The data presented on this website is a compilation of information from various sources; however, the information is not endorsed by HRSA and not dispositive in determining compliance with the 340B Drug Pricing Program. 340B stakeholders are ultimately responsible for 340B Program compliance and compliance with all applicable state and federal laws and regulations. Stakeholders are encouraged to contact the states in order to verify current policy/requirements.


Select State/Territory from the drop down

Medicaid Carve In Percentages

Current Quarter Prior Quarter
% Carve-IN Number of
340B CEs
Change from
Prior Quarter
% Carve-IN Number of
340B CEs

Medicaid State Details

  Retail

Drug Ingredient Cost

Professional Dispensing Fee

Required Claim Identifiers

Professional Dispensing Fee (Max Range)

  Provider or Facility Administered Drugs

Drug Ingredient Cost

Required Claim Identifiers

  Can Contract Pharmacies Dispense 340B Drugs

  Comments/Notes

Medicaid Contacts

Technical Contact

( )

Rebate Contact

( )

Policy Contact

( )

 

The Medicaid State Details Table Shows:

Retail Prescriptions

  • Drug Ingredient Cost – cost to submit to Medicaid for reimbursement
  • Required Claim Identifiers – any identifiers required by the state to accompany the claim
  • Professional Dispensing Fee (PDF) – amount Medicaid will pay for dispensing service
  • Professional Dispensing Fee (Max Range) – if the PDF varies, this is the max amount

Provider or Facility Administered Drugs

  • Drug Ingredient Cost – cost to submit to Medicaid for reimbursement
  • Required Claim Identifiers – any identifiers required by the state to accompany the claim

Can Contract Pharmacies Dispense 340B Drugs

  • Does the state permit dispensing 340B drugs through contract pharmacies. NOTE: Entities who want to dispense 340B drugs through contract pharmacies must have established an arrangement among the covered entity, the contract pharmacy and the State Medicaid agency to prevent duplicate discounts, and reported this arrangement to HRSA

Comments

  • Additional information outside the above data points.

The Medicaid Contacts table shows:

  • Technical, Rebate, and Policy contacts for the state’s Medicaid Drug Rebate Program liaisons
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