340B Drug Pricing Program
The soaring cost of prescription drugs strains patients, providers, and government budgets. The 340B Drug Pricing Program provides relief by making drug discounts available to essential hospitals, which use the savings to provide and expand services to vulnerable patients.
States can protect this key source of support for the nation’s health care safety net is by ensuring providers can use 340B-purchased drugs for Medicaid beneficiaries. Under Health Resources and Services Administration rules, hospitals and other covered entities may choose to purchase covered outpatient drugs for Medicaid beneficiaries at 340B discounts (“carve in”) or not (“carve out”). States have begun to exercise this authority, through Medicaid state plan amendments or legislation, to dictate whether covered entities can make this choice.
States are pursuing several trends related to 340B, including carve-out policies, duplicate discounts, rebate policies, and more.
Questions
Contact us at state@essentialhospitals.org or 202.585.0100.
New York Sues CVS for Interfering with 340B Provider Discounts
Aug. 2, 2022 ||The lawsuit alleges that, since acquiring third party administrator Wellpartner in 2017, CVS required 340B covered entities to work with Wellpartner.
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340B State Policy: Combating Discriminatory Payer Practices
July 22, 2022 ||
This State Policy Snapshot explores how legislatures are responding to the recent discriminatory actions by pharmacy benefit managers and other payers by enacting 340B-related nondiscrimination legislation.
view more »Michigan Enacts 340B Nondiscrimination Laws
March 8, 2022 ||The laws prohibit pharmacy benefit managers and insurance companies from discriminating against 340B Drug Pricing Program contract pharmacies and covered entities.
view more » State Policy Snapshot: Carving Out the Pharmacy Benefit from Medicaid Managed Care
Feb. 28, 2022 ||
States argue shifting pharmacy benefits from managed care to Medicaid fee-for-service can lead to savings, but removing 340B Drug Pricing Program benefits for managed care drugs can jeopardize essential hospitals’ 340B savings — a critical source of support.
view more » State 340B Policy: Mandating Carve-In, Carve-Out Policies
July 19, 2021 ||
Recently, some states have started to direct providers on which carve-in or carve-out options they take so the state can claim its rebates without concern of duplicate discounts. This State Policy Snapshot examines the current landscape of state carve-in and carve-out policies.
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