The American Hospital Association, the Maine Hospital Association and four safety-net hospitals filed a federal lawsuit in Maine on October 9, seeking to stop the Department of Health and Human Services' revised 340B drug-rebate pilot before it takes effect on January 1, 2027.
The hospital groups argue that replacing upfront drug discounts with after-the-fact rebates from 10 drugmakers across 21 drugs could impose more than $1 billion in annual administrative costs on hospitals — far above HHS's $537 million estimate.
The legal challenge follows the same court's December 2025 injunction that blocked the first version of the pilot, setting up another high-stakes courtroom fight over the federal drug-pricing program that allows qualifying hospitals to buy medications at steep discounts.
HHS has defended the rebate approach as a way to modernize the program, but hospital advocates warn it would undermine the financial foundation of safety-net care in communities that rely on 340B savings.
