Searchable state-by-state Medicaid 340B requirements
This resource has been created by the 340B Prime Vendor Program to assist stakeholders by combining the most recently available 340B-specific Medicaid data with publicly available federal data. Please note that additional requirements or contractual obligations that may be in place from third-party payers are not included in this resource.
Upon selecting a state in the drop-down menu, the Medicaid State Technical, Rebate and Policy contacts and details on the state’s retail prescriptions, provider- or facility-administered drugs, contract pharmacies and Medicaid Managed Care profiles will populate below. Each field is linked to the sourced data where additional information can be found.
Please note: The data presented on this page are compiled from various sources; however, the information is not endorsed by HRSA and not dispositive 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 to verify current policy/requirements.
State Medicaid agencies do not report 340B profiles to a central database. We appreciate assistance from the 340B community to report any inaccuracies or provide missing information. Please contact us via email or through Apexus Answers.
Technical contact
MAGELLAN HEALTH
martin vincent
MARTIN.SAMMANASUVINCENT@PRIMETHERAPEUTICS.COM11013 west broad street suite 500
glen allen, VA 23060
(612) 318-5702
Rebate contact
MAGELLAN HEALTH
jennifer mccray
JENNIFER.MCCRAY@PRIMETHERAPEUTICS.COM11013 west broad street suite 500
glen allen, VA 23060
(612) 329-4009
Policy contact
GEORGIA DEPT OF COMMUNITY HEALTH
peter d'alba
PETER.DALBA@DCH.GA.GOV2 martin luther king jr. drive se (east tower: 1952h)
atlanta, GA 30334
(770) 595-3822
Georgia Medicaid State Details as of 27-AUG-24
Retail Pharmacy Transactions - Fee For Service (FFS)
Drug Cost (submissions)
Drug cost type when 340B drugs are dispensed.
Drug Cost (reimbursements)
Drug cost type state plans reimburse at for 340B dispenses.
Required Claim Identifiers
Claim identifiers required to indicate 340B drugs were dispensed.
Professional Dispensing Fee (PDF)
The current professional dispensing fee for FFS 340B claims. Note: some states have ranges based on different factors.
Provider or Facility Administered Transactions Fee For Service (FFS)
Drug Cost (submissions)
Drug cost type when 340B drugs are administered.
Drug Cost (reimbursements)
Drug cost type state plans reimburse at for 340B dispenses.
Required Claim Identifiers
Claim identifiers required to indicate 340B drugs were administered.
Contract Pharmacies*
* Despite Federal position on dispensing through CP arrangements
Medicaid Managed Care Organization (MCO) Information
State uses MCO plans?
Does the state use MCO(s) to manage Medicaid services?
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MMCO Plans/Vendors |
Pharmacy Benefit Managers (PBMs) |
|---|---|
"Reimbursement for specialty drugs dispensed under the Georgia Medical Assistance program shall not exceed the lowest of the following and plus the professional dispensing fee (pdf): a) Select Specialty Pharmacy Rate (SSPR) or a) Select Specialty Pharmacy Rate (SSPR), orb) National Average Drug Acquisition Cost (NADAC), orc) Georgia Estimated Acquisition Cost (GEAC), ord) Georgia Maximum Allowable Cost (GMAC), ore) Federal Upper Limit (FUL), (PDF), orf) Provider submitted charges (including Usual and Customary Charges) (no Professional Dispensing Fee (PDF))Reimbursement for non-specialty drugs, dispensed under the Georgia Medical Assistance program shall not exceed the lowest of plus the Professional Dispensing Fee (PDF):a) National Average Drug Acquisition Cost (NADAC) or Georgia Estimated Actual Acquisition Cost (GEAC), orb) Georgia Maximum Allowable Cost (GMAC), orc) Federal Upper Limit (FUL), ord) Provider submitted charges (including Usual and Customary Charges