"Pennsylvania hospitals reinvest every dollar of 340B savings into the communities that need it most. Restricting this program doesn't save money - it closes doors for patients who have nowhere else to go."
— Nicole Stallings, President and Chief Executive Officer, Hospital and Healthsystem Association of Pennsylvania
Reported community benefit (2024)
$7.95B
Reinvested in patient care and community services - up 9% from 2023
PA hospitals in 340B
72
30% of Pennsylvania’s 235 hospitals (HAP Mar 2026 talking points)
States with contract pharmacy protection
21
29 states still lack enacted protection - including Pennsylvania
Share of total U.S. drug market (340B)
7%
HAP Mar 2026 materials cite Commonwealth Fund
“
The pharmacy at my hospital is the only reason I can afford my insulin. Without 340B, I don't know what I would do.
- Pennsylvania patient, safety-net hospital (name withheld)
What HAP is asking Congress to do
-
Protect the 340B discount
Keep hospital access to the outpatient drug prices Congress set for charity care and community benefit.
-
Defend contract pharmacy partnerships
Patients fill prescriptions through local and network pharmacies - not one distant site selected by manufacturers.
-
Oppose rules that shrink safety-net access
Rural and underserved communities keep an affordable path to medications hospitals are required to support.
What HAP is asking Pennsylvania government to do
-
Governor Shapiro's Office
Direct PA DHS to maintain and strengthen the 340B Drug Exclusion List and oppose any federal waiver that would reduce 340B participation for PA Medicaid patients.
-
PA Senate Health and Human Services
Advance contract pharmacy protection legislation this session. 21 states have already acted.
-
PA House Health Committee
Schedule hearings on contract pharmacy restriction impacts and move a companion bill before session ends.
U.S. contract pharmacy protection map
Live snapshot from dashboard at time of print.
Map loading from dashboard snapshot...
HRSA Program Integrity FY 2024
Covered entity audits
179
vs.
36x more hospital audits than manufacturer audits
HAP supports parity - hospitals and manufacturers should face the same level of federal scrutiny. The current imbalance is not a compliance argument; it is an equity argument.
Legal trends
Courts
States including AR, LA, MO, MN, TN, and RI prevailed when manufacturers challenged contract pharmacy protections. Key cases: PCMA v. Wehbi (8th Cir. 2022); LA Hospital Association v. Greenstein.
Bipartisan compromise: protection + reporting (2025)
CO, ME, OH, RI, and VT paired pharmacy protections with reporting requirements - a workable bipartisan model for federal legislation.
Vetoes
Some governors vetoed proposed 340B protections, including Virginia. Pennsylvania has not enacted standalone contract pharmacy protection as of March 2026.
Pennsylvania safeguards
PA already prevents duplicate discounts
- Manufacturers are not required to give both a 340B discount and a Medicaid rebate for the same drug. (42 U.S.C. 256b)
- PA DHS runs the 340B Drug Exclusion List and bills manufacturers for Medicaid rebates - hospitals may not use 340B-priced drugs on this list.
- Contract pharmacies give non-340B drugs to Medicare Advantage patients, and DHS bills manufacturers for rebates.
PA operating stakes
Why 340B is not optional for PA hospitals
- 49% of PA hospitals operating at a loss
- 53% losing money on labor and delivery
- 49% rural - contract pharmacies are the only access point for many patients
- 23 percent average savings on pharma purchases reinvested in care
What manufacturers argue - and the response
| Manufacturer claim |
Hospital / HAP response |
Evidence |
| 340B creates duplicate discounts - hospitals collect both a 340B discount and a Medicaid rebate. |
PA DHS runs the 340B Drug Exclusion List preventing this. Federal law (42 U.S.C. 256b) already prohibits duplicate discounts. |
PA DHS Exclusion List; HRSA program integrity rules |
| Hospitals use 340B savings for profit, not patient care. |
$7.95B in reported community benefit (2024, up 9%) funds free prescriptions, cancer screening, dental care, and rural services. |
340B Health 2024 community benefit report |
| Contract pharmacy networks are too large and unaudited. |
HRSA conducted 179 covered-entity audits vs. only 5 manufacturer audits in FY 2024. Hospitals face 36x more scrutiny than manufacturers. |
HRSA Program Integrity FY 2024 audit results |
Data stewardship: Questions about source interpretation, update cadence, or citation language can be directed to HAP policy and communications teams through haponline.org/contact.
Sources: MultiState · ASHP · America's Essential Hospitals (state law) · 340B Health · AHA (community benefit) · HRSA Program Integrity FY 2024 (audit counts) · 42 U.S.C. 256b (federal statutory basis)
Limitations: State law counts change as legislatures meet. Community benefit totals are self-reported aggregates, not independently audited.
Pennsylvania district map
Hospital points and district boundaries from live dashboard snapshot.
Map loading from dashboard snapshot...
