Date: June 4, 2021
To: All Medical Assistance Program Providers
Re: Correction for Reporting Actual
Acquisition Cost on Managed Care Plan Claims for Providers
Participating in the 340B Program
notice is a follow-up to the April
15, 2021 notice concerning billing requirements for providers participating in the
The April 15, 2021 provider notice stated the information in the notice applies to claims submitted
to the Department of Healthcare and Family Services (HFS) or one of the
Medicaid Managed Care Organizations (MCOs) for drugs purchased under the
federal 340B drug pricing program. This notice clarifies that reporting of
the actual acquisition cost (AAC) for 340B program purchased drugs only applies
to fee-for-service claims submitted to the Department. It does not apply to
claims submitted to one of the MCOs.
correction supersedes the statement in the earlier notice. All other material
in the April
15, 2021 notice remains the same.
AAC information for fee-for-service claims is necessary
so that the state is able to timely and appropriately receive rebates owed to
the Department from pharmaceutical manufacturers for drugs purchased outside of
the federal 340B program.
in this notice prohibits an MCO to require by contract that network pharmacies
report actual 340B acquisition cost.
The Department’s 340B Drug Pricing Frequently Asked Questions has been updated to
reflect the above policy and is posted to the Pharmacy webpage. Questions
regarding this notice may be directed to the Bureau of Professional and
Ancillary Services at 877-782-5565.
Kelly Cunningham, Administrator
Division of Medical Programs