After more than five years of work, the bipartisan Senate 340B “Group of Six” (G6) released the text of its comprehensive 340B reform legislation, the SUSTAIN 340B Act. The G6 released a partial SUSTAIN draft in 2024 that addressed issues such as contract pharmacies, a neutral claims clearinghouse, and Pharmacy Benefit Manager (PBM) “pick-pocketing.” The new bill expands on the partial version by adding provisions on additional issues including:
- Rebate Model: The bill would end any existing manufacturer rebate model within one year and require a transition to a neutral claims’ clearinghouse.
- Patient Definition: The bill establishes criteria for determining when an individual is considered a “patient” of a covered entity for 340B eligibility purposes. Importantly, it also limits the circumstances under which “referral prescriptions,” would qualify for 340B pricing.
- Child Sites: This section, which applies only to hospitals, establishes new requirements for creating new 340B-eligible child sites.
Additional information is available as part of a one-page summary. Look for a more detailed analysis and a comparison with the bipartisan House SECURE Act soon.