How does HRSA define Medicaid overlap and duplicate discounts under 340B?

HRSA defines a duplicate discount as occurring when a drug receives both a 340B discount and a Medicaid rebate. The agency views preventing this overlap as a shared duty between covered entities and state Medicaid programs, requiring accurate carve‑in or carve‑out designations and up‑to‑date records that align with HRSA’s 340B database and state billing identifiers.