The Michigan Department of Health and Human Services (MDHHS) recently released a final policy to modify hospital outpatient billing requirements for drugs purchased through the 340B drug pricing program. Existing policy requires 340B hospitals to bill 340B drugs at acquisition cost. Effective for dates of service on or after Jan. 1, 2024, hospitals may bill up to usual and customary charges for 340B acquired physician-administered drugs or products when provided in the hospital outpatient setting. This policy also revises the hospital outpatient 340B acquisition cost reporting and discontinues the 340B final settlement adjustment process. The MDHHS expects this change will have no reimbursement impact.
In addition, the policy revises 340B hospital cost reporting requirements. Annually, starting by December 2024, hospitals will be required to report 340B cost data for all Medicaid outpatient fee-for-service claims paid during the prior fiscal year.
Questions regarding this process should forwarded to the MDHHS Drug Rebate Specialist.
Members with questions should contact Vickie Kunz at the MHA.