MedicaidCoverageHigh impact
All Provider Bulletin 414: Changes in Exclusion of Designated 340B Drugs for MassHealth Fee-for-Service Coverage – Corrected
MassHealth·MA · Pharmacy·Pharmacy
Effective date
Jul 3, 2026
We identified it
Jun 24, 2026
Summary
Starting July 3, 2026, MassHealth will no longer reimburse for drugs acquired through the 340B Drug Pricing Program when billed through pharmacy point-of-sale adjudication in fee-for-service plans. Pharmacies must use non-340B stock for MassHealth patients or claims will be denied.
Action Required
Before July 3, 2026: Pharmacies billing MassHealth FFS must identify and separate 340B drug inventory from non-340B stock. Update pharmacy management systems to use only non-340B drugs for MassHealth FFS, PCC Plan, and Primary Care ACO members at point-of-sale. Train pharmacy staff on new dispensing protocols. 340B drug claims for these members will be denied after the effective date.