Participation in the 340B Drug Pricing Program

(A) Notification of Participation. Except for drugs that are excluded from coverage for MassHealth members through the 340B Drug Pricing Program, a hospital outpatient department or a hospital- licensed health center that is a 340B-covered entity may provide drugs that are billed through the medical setting (that is, not billed through pharmacy point-of-sale adjudication) to MassHealth members through the 340B Drug Pricing Program. Before filling the prescription, the hospital outpatient department or hospital-licensed health center must notify the MassHealth agency that the 340B-covered entity is registered and approved by the federal Office of Pharmacy Affairs (OPA). Any drug excluded from coverage for MassHealth members through the 340B Drug Pricing Program will be communicated by provider bulletin or other written issuance from the MassHealth agency, and be designated consistent with all requirements of M.G.L. c. 118E, §13L. Nothing will otherwise limit the rights of the MassHealth agency to exclude any or all drugs from coverage for MassHealth members through the 340B Drug Pricing Program. (130 CMR 410.468(B) Reserved) (C) Termination or Changes in 340B Drug Pricing Program Participation. A hospital outpatient department or hospital-licensed health center must provide the MassHealth agency 30 days’ advance written notice of its intent to discontinue, or change in any way material to the MassHealth agency, the manner in which it provides 340B outpatient drugs for its MassHealth patients. (130 CMR 410.468(D) Reserved) (E) MassHealth Coverage of 340B Drugs at Pharmacies. The MassHealth agency does not cover drugs billed through pharmacy point-of-sale adjudication when these drugs are acquired through the 340B Drug Pricing Program. (130 CMR 410.469 through 410.470 Reserved) 4. Program Regulations