A Bipartisan House Bill Would Delay the 340B Rebate Model. The Pilot Is Set to Start Jan. 1, 2027.
H.R. 10770 would keep 340B discounts up front through Dec. 31, 2028, pausing a pilot that makes safety-net providers pay full price and wait for rebates. Hospitals have also sued again. Nothing changes unless Congress or a court acts.
A bipartisan House bill, H.R. 10770, would delay the federal 340B rebate pilot by requiring up-front discounts from Jan. 1, 2027, through Dec. 31, 2028, the period when the Health Resources and Services Administration's (HRSA) pilot would otherwise begin.
Reps. Rob Bresnahan Jr. (R-Pa.), Debbie Dingell (D-Mich.), Tracey Mann (R-Kan.) and Lois Frankel (D-Fla.) introduced the 340B Rebate Model Delay Act on Oct. 9, according to Bresnahan's announcement. The bill was referred to the House Energy and Commerce Committee the same day. It would also bar federal funds from being used to implement the pilot or a substantially similar program during those two years, the American Hospital Association (AHA) said in its summary; the AHA endorsed the bill in an Oct. 15 letter.
If you practice at or refer to a 340B hospital or health center, this affects the cash flow of the organization that employs or hosts you. It is not a change to Medicare payment.
What is the 340B rebate model?
It replaces an up-front discount with a payment after the fact. Under the 340B Drug Pricing Program, eligible providers serving underserved communities buy covered outpatient drugs at discounted prices. Under the rebate model, they would instead pay full price and receive the discount later as a rebate, which the sponsors say would create cash-flow pressure and administrative burden for safety-net providers.
HRSA published the revised pilot in the Federal Register on Aug. 3, 2026, with a Jan. 1, 2027 start, according to a summary by the law firm Baker Donelson. It covers drugs on the Centers for Medicare and Medicaid Services (CMS) selected drug list for price applicability years 2026 and 2027, which the firm says were less than 5.5 percent of 2025 340B sales volume. Covered entities would generally have to request rebates within 45 days of dispensing, and manufacturers would have 10 days from a complete claim to pay or deny with documentation. HRSA announced earlier this month which manufacturers and products will take part, HFMA reported.
A rebate model is a working-capital problem first and a prescribing problem second. The question for a physician leader is whether the pharmacy and finance teams can submit claims data on time, because late claims mean unrecovered discounts.
What do the sponsors say?
Dingell said in the release that safety-net providers are not in a financial position to front this money. Mann said the bill would stop the rebate model through 2028 and provide certainty for rural providers. Frankel said limited resources should go toward caring for patients. The release lists 22 endorsing organizations, including the AHA, America's Essential Hospitals, 340B Health and the National Association of Community Health Centers.
Is the pilot also in court?
Yes, again. The AHA, the Maine Hospital Association and four safety-net hospitals sued in federal court in Maine on Oct. 9 to stop the revised pilot, the AHA said. The same court blocked the earlier version: after a December 2025 suit, Judge Lance E. Walker barred the first pilot from taking effect on Jan. 1, 2026, and in February 2026 vacated and remanded the approvals, per Baker Donelson.
What to watch
The Jan. 1, 2027 date stands unless the court or Congress acts, and the bill's latest action is committee referral. If you hold a leadership role at an affected entity, ask whether your pharmacy team knows which of its frequently purchased drugs are in the pilot and whether the claims workflow is ready before the start. For related drug-payment litigation, see our coverage of the GLOBE suit.
Reported, fact-checked and edited by The Script Pad's editorial staff.
This article is for professional education and does not replace clinical judgment. Treatment decisions should be based on the individual patient and current guidelines.
