The 340B Rebate Model Is Moving Forward
✱
The 340B Rebate Model Is Moving Forward
✱
The 340B Rebate Model Is Moving Forward
✱
The 340B Rebate Model Is Moving Forward
✱
340B PILOT UPDATE
A New Rebate Model.
A Clear Path Forward.
HRSA’s Office of Pharmacy Affairs has published the approved manufacturer plans for the 340B Rebate Model Pilot Program. The approved plans are scheduled to take effect January 1, 2027.
Under the Pilot, covered entities will continue purchasing participating drugs through their existing 340B wholesaler accounts. For drugs included in an approved rebate plan, the purchase price will shift to WAC, with the difference between WAC and the applicable 340B ceiling price subsequently returned through a rebate following submission of the required claims data.
Pillr Health has been preparing for this transition and is ready to support our clients through implementation and ongoing operations.
What Covered Entities Need To Know
TIMING
January 1, 2027
Effective Date
Approved manufacturer rebate plans are scheduled to take effect January 1, 2027.
ORDERING
Existing 340B Wholesaler Accounts Remain In Place
Covered entities will continue ordering participating products through their existing 340B wholesaler accounts. Manufacturers will work with wholesalers to load WAC pricing for drugs subject to the Pilot.
CLAIMS
Claims-Based Rebate Submission
Covered entities will submit HRSA-approved claims data through the designated rebate platform. Claims generally must be submitted within 45 calendar days of the date of dispense.
PRICING
Rebates Based On The 340B Ceiling Price
The rebate will represent the difference between WAC and the applicable 340B ceiling price on the date of dispense.
PROCESSING
10-Day Rebate Processing Requirement
Manufacturers must pay the rebate or provide a documented denial within 10 calendar days following a complete data submission.
COMPLIANCE
Existing 340B Requirements Continue
The Pilot does not change the 340B ceiling price, covered entity eligibility, or patient eligibility requirements. Covered entities must continue maintaining auditable records and complying with existing diversion and duplicate discount requirements.
READY TO SUPPORT YOU
Pillr Health Is Rebate Ready
UPCOMING WEBINAR
What Covered Entities Need
To Know Before January 1
Join us for a discussion focused on the 340B Rebate Model Pilot Program, what’s changing for covered entities, and how to prepare for January 1, 2027.
Preparing For January 1, 2027
Pillr Health is actively reviewing the approved manufacturer plans and translating the requirements into implementation workflows for our clients. Over the coming weeks, we will:
01 / REQUIREMENTS
Define The Requirements
Review and validate requirements across each approved manufacturer plan
02 / IMPLEMENTATION
Prepare Implementation
03 / READINESS
Ensure Client Readiness
OUR GOAL
Make this transition as straightforward as possible while giving covered entities the visibility and controls they need to confidently manage the new rebate process.
