MedicaidAdministrativeMedium impact
Correction for Reporting Actual Acquisition Cost on Managed Care Plan Claims for Providers Participating in the 340B Program
Illinois Medicaid - HFS·IL · Pharmacy·Provider Notice
Effective date
Jun 4, 2021
We identified it
Jun 20, 2026
Summary
This policy corrects earlier guidance about reporting actual acquisition cost (AAC) for 340B program drugs. AAC reporting is now clarified to apply ONLY to fee-for-service Medicaid claims submitted directly to the state, NOT to claims submitted to Medicaid Managed Care Organizations (MCOs).
Action Required
Immediately: Billing team must ensure that actual acquisition cost (AAC) reporting for 340B program drugs is only applied to fee-for-service Medicaid claims submitted directly to Illinois HFS. Do NOT report AAC on claims submitted to Medicaid MCOs. Update billing system rules and staff training to reflect this distinction between fee-for-service and managed care Medicaid claims.