Attention Nevada Medicaid-enrolled 340B Covered Entities: Reminder: Nevada Medicaid Fee-For-Service (FFS) Will Integrate the 340B Ceiling Price into the 340B Reimbursement Methodology Beginning October 1, 2026

By September 30, 2026: Billing team must review and update all 340B drug billing processes to account for 340B ceiling price integration. (1) Verify that 340B AAC has been submitted to Nevada Medicaid and is current; coordinate with pharmacy/materials management to confirm submission. (2) Update billing software logic or documentation to reflect that reimbursement may be calculated using the 340B ceiling price when it is the lowest applicable value. (3) Establish internal process for tracking 340B ceiling price calculations using AMP and URA values from HRSA resources. (4) Train billing staff on the new methodology and direct them to reference the Nevada Medicaid and Nevada Check Up Pharmacy Manual for 340B billing guidelines. (5) Document the policy change in internal procedures and compliance files. For pricing disputes related to 340B ceiling prices, direct inquiries to the HRSA 340B Administrative Dispute Resolution process rather than using standard Nevada Medicaid dispute channels. Contact RxInfo@nvha.nv.gov with policy and billing questions. Failure to implement these changes may result in claim denials or reimbursement at incorrect rates beginning October 1, 2026.