Article
What changed this week
On Feb. 25, HRSA moved the comment deadline on its request for information about a 340B rebate model from March 19 to April 20. The extension followed a Feb. 19 letter from the American Hospital Association, the Association of American Medical Colleges and other hospital groups arguing that 30 days was not enough to answer the agency’s detailed questions. AHA News also reported that HRSA indicated a future pilot could extend to all drugs in Medicare’s drug price negotiation program through 2027.
How we got here
HRSA first floated the rebate concept last August. Under it, covered entities would pay full price for certain drugs up front and later receive rebates from manufacturers. Hospital groups sued, and in December a federal judge blocked the pilot just before its planned Jan. 1 start. The 1st U.S. Circuit Court of Appeals declined to lift the block. In early February, HHS agreed to vacate the pilot and send it back to HRSA, which issued the current request for information on Feb. 13.
The two sides remain far apart. 340B Health estimates a rebate model would force disproportionate share hospitals to float an average of $72 million a year, a figure PhRMA disputes. Drugmakers say rebates would usually be paid within 10 days of dispensing, before hospitals pay wholesalers, and argue the program needs more oversight.
Why the evidence matters
HRSA has asked for supporting facts, research and evidence, and the first pilot fell in court partly over its effect on safety-net providers. A record built from real hospital data will carry more weight in any new design, and in any future litigation, than general statements of concern.
What to do before April 20
- Model the cash flow. Estimate the working capital needed to buy affected drugs at full price, using actual purchasing volumes and payment terms, and test a wider drug list.
- Measure the administrative load. Count the staff time and system changes needed to submit claims data and reconcile rebates.
- Show the program impact. Tie 340B savings to specific services, such as clinics, pharmacy programs or charity care, that would be at risk.
- File and coordinate. Submit your own comments and share data with your state association and national groups so the industry record is consistent.
Archive entry for Feb 28, 2026, added Nov. 11, 2026.
Sources
- HRSA extends deadline to April 20 for comments on 340B rebate model RFI (AHA News, Feb 25, 2026)
- HRSA extends comment period on 340B rebate proposal (Becker’s Hospital Review, Feb 26, 2026)
- Hospitals urge HHS to extend comment deadline on 340B rebate pilot (Becker’s Hospital Review, Feb 20, 2026)
- Why drugmakers and hospitals are fighting over the 340B program (Healthcare Brew, Feb 20, 2026)
- HHS releases RFI on new 340B rebate model (AHA News, Feb 13, 2026)