340B Program Overview

Jan 29, 2024

MaineCare does not allow contract or retail pharmacies to enroll in the 340B Medicaid drug program, either directly or under subcontract with a 340B entity. MaineCare is Fee For Service (FFS).

All 340B providers who submit claims to MaineCare must determine whether they will use 340B drugs for their MaineCare patients (carve-in to the program) or whether they will purchase drugs for these patients through other mechanisms (carve-out of the program).

In alignment with existing MaineCare policy, 340B providers are responsible for completing the following steps:

• Enrolling with the Health Resources and Services Administration’s (HRSA) Office of Pharmacy Affairs.
• Confirming the HRSA Medicaid Exclusion File (MEF) accurately represents their current Medicaid Exclusion status.
• Completing the MaineCare 340B Provider Agreement found on the MIHMS Health PAS Online Portal
• Including a full list of service locations that will dispense 340B drugs on their 340B Provider Agreement.
• Uploading the signed 340B Provider Agreement to the MIHMS Health PAS Online Portal when updating enrollments using a maintenance case.

MaineCare will verify 340B provider status on the HRSA website prior to co-signing the 340B Provider Agreement or reimbursing a 340B provider. 340B provider status will also be validated at least quarterly thereafter. This is part of MaineCare’s process to avoid duplicate discounts.

Please contact Megan Dinsmore, Provider Relations Specialist, with questions.