A coalition of hospital associations and individual safety‑net providers recently filed suit in the U.S. District Court for the District of Maine challenging the Health Resources and Services Administration’s (HRSA) newly announced 340B Rebate Model Pilot Program, alleging violations of the Administrative Procedure Act (APA). As framed in the complaint, the program would replace the 30‑year‑old practice of offering 340B discounts at the point of sale with a post‑dispense rebate for a set of high‑volume drugs, compelling covered entities to pay wholesale acquisition cost (WAC) upfront and then pursue reimbursement from manufacturers. The plaintiffs contend the shift will impose hundreds of millions of dollars in administrative and cash‑flow costs on safety‑net hospitals, jeopardize care in rural and underserved communities, and reflect a sudden, unexplained reversal of HRSA’s longstanding position that upfront discounts are the most effective and efficient way to administer the program.







