# The 340B ACCESS Act: What You Need to Know

The 340B program is a federal discount program that lets certain hospitals and health centers buy medications at significantly reduced prices from drug manufacturers. This bill makes major changes to how that program works, with the goal of making sure the discounts actually benefit patients and prevent organizations from misusing the system for profit.

Right now, some large hospitals and health systems have been accused of buying drugs at steep discounts through 340B and then marking them up significantly when billing patients or insurance companies—pocketing the difference without necessarily using those profits to help uninsured or low-income patients. This bill tries to crack down on that practice. It creates stricter rules about who qualifies as a "patient" eligible for 340B discounts, requiring that patients actually receive care from the organization (not just pick up a prescription), that they have an ongoing relationship with the provider, and that they've had an in-person visit within the past 12 to 24 months depending on the type of facility. It also limits which organizations can participate—large nonprofit health systems with over $1 billion in annual revenue face new restrictions, as do nonprofits that recently became affiliated with hospitals.

The bill also addresses the problem of duplicate discounts, where Medicaid ends up paying twice for the same discount. It requires clearer tracking systems so that when a 340B drug is dispensed to a Medicaid patient, the state doesn't also demand a manufacturer rebate on top of the 340B discount. Additionally, the bill creates new transparency requirements, forcing covered entities to report how they're using the money they save from 340B discounts and allowing federal audits to verify compliance. For patients, the practical effect should be that 340B discounts are more likely to translate into lower out-of-pocket costs rather than just higher profits for large health systems.