Bipartisan Senate Bill Would Preserve Drug Discounts for Safety-Net Hospitals and Shut Down a Rebate Pilot

A bipartisan group of six senators introduced the Supporting Underserved and Strengthening Transparency, Accountability and Integrity Now and for the Future of 340B Act, known as the SUSTAIN 340B Act, on August 5, 2026. Sponsors included Senators Jerry Moran, Shelley Moore Capito, John Boozman, Tammy Baldwin, Tim Kaine, and John Hickenlooper.

The 340B Drug Pricing Program allows certain federally designated safety-net hospitals, community health centers, and clinics to purchase outpatient drugs at substantially reduced prices from manufacturers. Those entities use the savings to fund services for low-income and uninsured patients. The program serves thousands of participating sites across the country, including hospitals that serve Medicare beneficiaries.

The bill directly addresses a dispute over whether drug manufacturers may require covered entities to use a rebate model rather than receiving discounted prices at the point of purchase. The SUSTAIN 340B Act would sunset any rebate model pilot within one year of enactment, preserving the current point-of-purchase discount structure.

In exchange, the bill would create an independent data clearinghouse to monitor for drug diversion and duplicate discounts, two longstanding concerns in the program. The legislation would also codify the use of contract pharmacies, while adding registration and audit requirements for those arrangements.

Covered entities would report program data through Medicare cost reports, including patient financial demographics and charity care as a share of operating costs. The bill has not yet received a committee hearing.