The survey shows how each state reimburses 340B covered entities, how states contract with pharmacies for 340B drugs and the steps states take to avoid duplicating discounts.
The survey found that 12 states rely solely on the Office of Pharmacy Affairs Medicaid Exclusion File to identify 340B drugs billed to the program to avoid duplicate discounts, while 22 states rely solely on claims-level identifiers and the other states rely on both.
One state prohibits all covered entities from using 340B drugs for Medicaid beneficiaries, and one state permits 340B drugs only for family planning clinics.
Almost two-thirds of states prohibit 340B contract pharmacies, the survey found.
Though Medicaid programs reimburse states for 340B drugs at actual acquisition cost, dispensing fees for 340B drugs also vary widely by state, from a low of $2.32 per prescription to a high of $21.28 per prescription.
Most states set dispensing fees between $10 and $11 per prescription.
Manatt Health reviewed statutory, regulatory and subregulatory guidance from each state’s Medicaid program and gathered input from state officials to conduct the survey.
Read the full survey here.
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