340B Rebate Model Pilot Program

On February 13, 2026, the Health Resources and Services Administration (HRSA) released a request for information (RFI) on the potential use of rebates in the 340B program. This comes after the failed attempt to launch a 340B rebate model pilot last year that was halted by the Courts due to a lack of administrative record. NACHC will submit comments on the detrimental impact of a rebate program to Community Health Centers. HRSA extended the original 30-day comment period, and comments are due April 20, 2026. 

HRSA also released an additional Information Collection Request (ICR) on the potential burden of the 340B Rebate Model Pilot Program, which is due April 27, 2026.  NACHC is working to ensure Community Health Center advocates are equipped to respond in a coordinated, data-driven way. 

• ​NACHC 340B Rebate Model RFI Long Template Comment Letter​
• ​NACHC 340B Rebate Model RFI Short Template Comment Letter
• NACHC 340B Rebate Model ICR Template Comment Letter

What is Different from the Previous RFI? 

• We have more insight from the previously approved manufacturer plans. 
• HRSA is seeking to strengthen the administrative record in light of the American Hospital Association (AHA) lawsuit 
• The RFI has specific questions and requires tailored data for each response 

The RFI raises the question of whether the rebate is only for Inflation Reduction Act (IRA) drugs 

The previous 340B rebate pilot was set to begin January 1, 2026, and would have required all covered entities, including community health centers , to pay the full price upfront for selected drugs dispensed to 340B eligible patients under HRSA’s 340B Rebate Model Pilot Program. This reverses the traditional 340B model in which discounts are applied upfront. All manufacturers chose Beacon as their IT platform, which would be responsible for validating eligibility for 340B rebate claims and issuing rebate payments. 

Under the original pilot, the ten drugs from nine manufacturers subject to the Medicare Drug Price Negotiation Program (MDPNP) for 2026 were approved to participate in the pilot. For more information on the MDPNP and the Inflation Reduction Act (IRA), see NACHC’s IRA webpage. 

Important Links: 

• HRSA’s 340B rebate model pilot webpage 
• HRSA’s email to submit questions and issues about the pilot: [email protected]  
• Beacon registration 
• Beacon FAQ
• 340B Rebate Model Pilot Resource Sheet
• Manufacturer policy documents  

NACHC/FQHC 340B Compliance toolkit:

• Congressional 340B Rebate Model One Pager
• Congressional Talking Points on 340B Rebate Pilot Program
• FQHC 340B Compliance Calculator & Instructions 
• Rebate Model Pilot 101  
• Rebate Model Pilot FAQ
• Rebate Model Contract Pharmacies FAQ
• Beacon Rebate Model FAQs: Top Priority for CHCs
• Slides and Recording from NACHC’s Part 1 November Webinar 
• ​Slides​​​ and Recording from NACHC’s Part 2 December Webinar
• ​Slides​​​ and Recording from NACHC’s February Webinar on the 340B Rebate Program RFI
• Slides and Recording From NACHC’s March Office Hour
• Slides and Recording From NACHC’s April Office Hour