HRSA clears 10 drugmakers for revised 340B rebate pilot starting 2027
The Health Resources and Services Administration said on October 1, 2026 that it approved 10 drug manufacturers, including AbbVie, Amgen, AstraZeneca, Pfizer, Merck and Teva, to take part in its revised 340B Rebate Model Pilot Program covering 21 outpatient drugs. Instead of giving 340B hospitals and clinics an upfront discount at purchase, participating manufacturers will pay rebates after the fact once a claims-verification platform confirms a patient was eligible; the pilot launches January 1, 2027 and runs at least a year, with HRSA due to publish a performance evaluation by April 30, 2028. HRSA says the model is meant to cut fraud and improve transparency in the discount program; the American Hospital Association says it will impose new administrative and financial burdens on safety-net providers and is weighing ways to stop it.
Why it's notable: 340B discounts are a major source of revenue for safety-net hospitals, rural providers and community health centers, so switching from upfront discounts to after-the-fact rebates changes cash flow and billing work for any clinic enrolled in the program.
Update 2026-10-08: On October 8, 2026, the American Hospital Association, the Maine Hospital Association and four safety-net hospitals filed suit in U.S. District Court in Maine against HHS Secretary Robert F. Kennedy Jr. and HRSA Administrator Thomas J. Engels, with a motion for a temporary restraining order to block the pilot's January 1, 2027 start. The plaintiffs say HRSA underestimated compliance costs, which they put at more than $537 million a year, and note the same court blocked a similar rebate model from taking effect in January 2026. (American Hospital Association, HFMA)