Hospitals Urge Court to Halt 340B Rebate Pilot Before 2026

Hospitals across the United States are taking decisive action against a new pilot program proposed by the Health Resources and Services Administration (HRSA). The American Hospital Association, in partnership with a Maine hospital group and four safety-net health systems, has filed a request with a district court in Maine to temporarily block the implementation of this program. The pilot is set to begin on January 1, 2026 and would allow drug manufacturers to provide after-the-fact rebates rather than upfront discounts for hospitals participating in the 340B Drug Pricing Program.

The 340B program is designed to help healthcare providers serving low-income and uninsured patients by allowing them to purchase outpatient drugs at significantly reduced prices. By shifting to a rebate model, hospitals argue that the program’s effectiveness could be undermined, ultimately impacting patient care.

The hospitals’ concern centers around the potential for reduced financial support. They assert that upfront discounts are crucial for maintaining their ability to provide necessary services to vulnerable populations. According to the American Hospital Association, the proposed changes may lead to increased costs for healthcare providers, which would likely be passed on to patients.

In their request, the coalition of hospitals emphasizes the need for a thorough examination of the pilot program’s implications. They argue that the HRSA has not sufficiently addressed how this new approach would affect access to affordable medications for their patients. The Maine hospital group and its partners are advocating for a pause on the program until a comprehensive review can be conducted.

As the situation develops, the hospitals remain firm in their stance. They are calling on the court to recognize the potential risks associated with the rebate model and to provide a temporary restraining order against the HRSA to prevent the pilot from commencing as planned.

The outcome of this case could have significant ramifications for the healthcare landscape, particularly for safety-net hospitals that depend on the financial relief provided by the 340B program. As the court deliberates, stakeholders from across the healthcare sector are closely monitoring the developments, recognizing the broader implications for drug pricing and patient access to care.