Four House lawmakers, Reps. Rob Bresnahan, R-Pa., Debbie Dingell, D-Mich., Tracey Mann, R-Kan., and Lois Frankel, D-Fla., have introduced bipartisan legislation that would pause HRSA’s 340B rebate model pilot.
Here are six things to know:
- The bill, the 340B Rebate Model Delay Act, would require drugmakers to provide 340B discounts upfront at the time of purchase from Jan. 1, 2027, through Dec. 31, 2028. It would also bar the use of federal funds to implement the rebate pilot or a substantially similar program during that period.
- The pause would give Congress time to consider broader 340B reform, including the SECURE 340B Act in the House and the SUSTAIN 340B Act in the Senate, according to an Oct. 9 statement from Advocates for Community Health. The group said health centers could be forced to cut services if they have to absorb full drug costs while awaiting rebates.
- In an Oct. 13 statement, America’s Essential Hospitals said the pilot would shift financial and operational risk onto safety-net providers and urged Congress to act before the Jan. 1 start. Advocates for Community Health said the National Rural Health Association, the Children’s Hospital Association, the National Association of Community Health Centers, the American Hospital Association and RWC-340B also support the bill, and that it plans to push for the delay to be attached to the year-end package during the December lame-duck session.
- HRSA approved 10 drugmakers on Oct. 1 for a revised pilot set to begin Jan. 1, after a federal court in Maine vacated an earlier version and sent it back to the agency. The AHA has asked Congress to permanently bar rebate models in comments on the SECURE 340B Act, and hospital leaders have said rebates could create cash flow and staffing strains.
- Under the rebate model, participating hospitals and health centers would pay higher prices upfront for certain drugs and seek rebates afterward, instead of receiving discounts at purchase.
- The bill follows an Oct. 9 lawsuit in which the AHA, the Maine Hospital Association and four hospitals asked the U.S. District Court for the District of Maine to block the revised pilot, which they say could impose more than $1 billion in annual administrative costs on hospitals.
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