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.
Technical contact
CONDUENT
gary peton
GARY.PETON@CONDUENT.COM1003 bishop street suite 1600 pauahi tower
honolulu, HI 96813
(808) 952-5591
Rebate contact
CONDUENT
gary peton
GARY.PETON@CONDUENT.COM1003 bishop street suite 1600 pauahi tower
honolulu, HI 96813
(808) 952-5591
Policy contact
HAWAII MED-QUEST
marcy ann healey
MHEALEY@DHS.HAWAII.GOV601 kamokila boulevard room 506b
kapolei, HI 96707
(808) 692-8115
Hawaii Medicaid State Details as of 29-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.
Medicaid Managed Care Organization (MCO) Information
State uses MCO plans?
Does the state use MCO(s) to manage Medicaid services?
|
MMCO Plans/Vendors |
Pharmacy Benefit Managers (PBMs) |
|---|---|
| Aloha Care | CarelonRx |
| HMSA Quest | CVS Health / Caremark |
| Kaiser Permanente | MedImpact Healthcare Systems |
| Ohana Health Plan / Wellcare Ohana | Cigna / Evernorth / Express Scripts |
| United Healthcare Community Plan | UnitedHealth / OptumRx |
Contract Pharmacies*
* Despite Federal position on dispensing through CP arrangements
Entities to complete an application for a Medicaid ID number specific for use in billing 340B medication using DHS Form 1139 (Medicaid Provider Application form), which can be found at the Med-QUEST Division website at www.med-quest.us