PHILADELPHIA, September 24, 2026 — In a study of 75 340B US hospitals’ financial assistance policies as of July 1, 2026, only 13 (17%) clearly indicate how they provide pharmaceutical assistance to patients or how patients may receive discounts on needed medicines, matching results of prior research released in May 2022.

The research, published today by the Center for Public Health Law Research at Temple University’s Beasley School of Law with funding from the Pharmaceutical Research and Manufacturers of America (PhRMA), collected Financial Assistance Policies (FAPs) and related debt collection policies from a sample of 75 US hospitals participating in the federal 340B program that includes the largest hospital by revenue in each state and the remaining hospitals were the next largest 340B hospitals by patient revenue in the nation. The sample of 340B hospitals changed between the May 2022 analysis and this current analysis based on hospital revenue. Sixty of the hospitals overlap between the samples.  

With more than 2,500 340B hospitals nationwide, this research provides insight into how hospitals are providing financial assistance in the absence of other legally mandated transparency measures.  

“This new research shows that persistent gaps remain in 340B hospitals’ financial assistance policies, particularly when it comes to helping patients access affordable outpatient medicines. The limited changes from our original research in May 2022 also highlights a broader concern: the 340B program includes no measures to assure that program savings are being directly used to support care for low-income populations, and many debt collection policies often fail to protect patients from aggressive debt collection actions if they are unable to pay for their care,” said Jonathan Larsen, JD, MPP, Legal Technology Manager at the Center and lead researcher on the project.

The research also finds:

• Hospital policies often allow the use of aggressive debt collection measures. Of the 68 hospitals that included debt collection actions in their policies, just 13 specifically prohibited the use of extraordinary collections actions (ECAs), which can include liens, foreclosures, and civil actions when patients fail to pay bills. Although, this reflects an improvement from 2022, more than half of the 340B hospitals in the 2026 sample still did not specify any limits on the use of ECAs, which may leave patients exposed to aggressive debt collection measures and underscores the need for clearer patient protections and stronger public accountability.
• Most hospitals do not publicly describe prescription drug affordability assistance and some refer patients to manufacturer assistance. Despite participating in the 340B program, which provides participating hospitals with discounts on outpatient medicines, 83 percent of hospitals did not include information about prescription drug assistance in their FAPs. Of the 13 hospitals that provided any details, five hospitals specifically reference helping patients utilize manufacturer-provided copay assistance programs to pay for their medicines.
• Financial assistance can be difficult to access. Patients may also struggle to understand their options when financial assistance is denied. While 44 hospitals in the study group detailed their appeals process for responding to a denial of financial assistance, 31 hospitals did not. Although an improvement from 2022 when fewer than half of hospitals in the sample detailed their appeals process, a substantial share of 340B hospitals today still fail to clearly explain how patients can challenge a denial of assistance. Lack of clear appeals processes can disadvantage patients attempting to qualify for assistance with hospital costs.
• Free-care eligibility varies widely. Many hospitals also offer free care to qualifying low-income patients, with eligibility for this free care continuing to vary widely. More than half of all 340B hospitals in this sample limited free care to patients below 300 percent of the federal poverty guidelines.

A Policy Brief released alongside the data notes: “The variation in 340B hospitals’ financial assistance policies identified in this analysis suggest that stronger transparency requirements and clearer patient-affordability protections should be included in 340B reform legislation to both improve policymakers’ ability to assess the program’s impact and help ensure that 340B benefits are more consistently directed to the low-income and vulnerable populations it is intended to support."

The project examined the policies in the 51 largest 340B hospitals by revenue in each state and the District of Columbia along with 24 hospitals that were the next largest 340B hospitals by revenue in the nation for the 2022 fiscal year.  

The Center for Public Health Law Research at Temple University Beasley School of Law creates and advances research on the health effects of laws and policies. Learn more at phlr.temple.edu.