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
CHANGE HEALTHCARE
shari martin
SMARTIN@CHANGEHEALTHCARE.COM45 commerce drive suite 5
augusta, ME 04332
(207) 622-7153
Rebate contact
CHANGE HEALTHCARE
kristen carlson
KCARLSON@CHANGEHEALTHCARE.COM45 commerce drive suite 5
augusta, ME 04332
(207) 622-7153
Policy contact
DEPARTMENT OF VERMONT HEALTH ACCESS
lisa brouillette hurteau
LISA.HURTEAU@VERMONT.GOV280 state drive nob 1 south
waterbury, VT 05671-1010
(802) 585-8629
Vermont Medicaid State Details as of 28-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?
|
MMCO Plans/Vendors |
Pharmacy Benefit Managers (PBMs) |
|---|---|
"Green Mountain Care is mandatory for most beneficiaries in the state and covers most Medicaid services, except long-term services and supports which are provided on a fee-for-service basis through a separate Choices for Care program. Green Mountain Care uses a public managed care model in which the Vermont Agency for Human Services (AHS), the state Medicaid agency, oversees the state’s Department of Vermont Health Access (DVHA), which serves as the state’s sole managed care organization"