# 119-hr-5256: 340B ACCESS Act 119-hr-5256, 340B ACCESS Act, is a 119th Congress bill sponsored by Rep. Carter, Earl L. "Buddy" [R-GA-1] (R-GA); status introduced; PRIA reads it as touching household money (as of 2026-04-21). - Canonical: https://policyrisk.com/legislation/119-hr-5256 - As of: 2026-04-21 - Plain-text twin of the page above; the HTML and this file carry the same facts. ## Facts - Bill: 119-hr-5256 - Congress: 119 - Title: 340B ACCESS Act - Status: introduced - Introduced: 2025-09-10 - Sponsor: Rep. Carter, Earl L. "Buddy" [R-GA-1] (R-GA) - Cosponsors: 1 - Policy area: Health - Touches household money: yes - Last recorded action: 2026-04-21 ## Summary **Targets 340B discounts to patients served by safety‑net providers.** The bill tightens who counts as a 340B patient, creates strict hospital off‑campus “child site” rules, and tightly regulates contract and mail‑order pharmacies while adding affordability caps, public margin reporting, a real‑time claims clearinghouse, and stronger penalties and audit powers. - Families and patients: Hospitals and nonhospital providers must use sliding fee scales that cap out‑of‑pocket costs per dispense at $0 for incomes below poverty, up to $35 for those under 200% of poverty, and up to $50 for higher incomes. Telehealth prescriptions generally qualify only after an in‑person visit within six months unless alternate records show benefit eligibility. - Hospitals and community providers: Off‑campus child sites must meet strict Medicare cost, ownership, charity care, Medicaid share, and shortage‑area tests to buy 340B drugs. Missing registration or transfer rules triggers repayment of discounts with monthly compounded interest and civil penalties starting at $2,500 per violation. - Pharmacies, manufacturers, and PBMs: Contract pharmacies must register, follow auditable compliance steps, and some hospitals are limited to five contract pharmacies. Manufacturers only must supply drugs to registered addresses or approved contract pharmacies. The bill sets flat fee limits for dispensing and third‑party administrators, creates layered civil penalties including up to $3,000 per claim and up to ten times improper remuneration, and bans PBM discrimination with penalties up to $5,000 per violation per day. ## Cosponsors (1) - Rep. Harshbarger, Diana [R-TN-1] (R-TN), 2025-09-10T00:00:00.000Z ## Provisions PRIA read - Insurers and PBMs barred from 340B bias: benefit, high. If enacted, group plans, insurers, and PBMs could not treat 340B providers, pharmacies, or patients worse because of 340B. They could not pay less, charge extra fees, block networks, impose special audits, or deny coverage just because a drug is 340B. Contracts that do this would be void. PBMs coul… - Hospital drug bills capped by income: benefit, medium. If enacted, hospitals would cap what you pay per 340B drug fill or administration. If your income is below poverty, you pay $0. At 100%–199% of poverty, you pay the lesser of 20% of the normal out‑of‑pocket or $35. At 200%+ of poverty, you pay the lesser of 30% or $50. The $35 and $50 caps would ri… - Tighter 340B patient and telehealth rules: cost, medium. If enacted, fewer prescriptions would count for 340B prices. The drug would need to be tied to care you got at the 340B site, ordered by its provider, and given or dispensed at an approved location. You would need a recent in‑person visit with the entity (within 12 months for some hospitals, 24 mon… - Federal rules override state 340B laws: mixed, high. If enacted, federal 340B rules would override state or local laws that differ from or relate to 340B. States could not add extra rights or duties about 340B beyond federal law, with a narrow exception for certain federal implementation rules. This preemption would begin one year after enactment. - Nationwide 340B claims tracking and audits: mixed, high. If enacted, the Secretary would hire an independent clearinghouse within one year to collect 340B claim data and flag duplicate discounts. Covered entities would have to send claim‑level data within 45 days and use 340B or non‑340B claim modifiers on all payors. The clearinghouse would notify parti… - Flat fees and penalties for 340B pharmacies: mixed, medium. If enacted, third‑party administrators and contract pharmacies would have to use flat fees not tied to drug price. A contract pharmacy’s per‑fill fee could not exceed 125% of its average dispensing fee paid by all payors in the last full year. Covered entities would need enforceable written agreeme… - New limits for nonhospital entities and subgrantees: mixed, medium. If enacted, nonhospital entities would need to be nonprofit or public and could buy 340B drugs only for patients at registered sites and within a grant’s scope and time. Entities would be responsible for subgrantee compliance and records. Ongoing in‑kind help over $25,000 per year (CPI‑U adjusted)… - Stricter rules for hospital child sites: mixed, medium. If enacted, off‑campus hospital sites could join 340B only if they meet strict tests. Sites would need to be on the Medicare cost report, be wholly owned, meet Medicare provider‑based standards, post charity care and sliding fee policies, provide more than drug dispensing, and be in a service‑short… - Purpose of 340B program clarified: mixed, low. If enacted, the law would state that 340B discounts are meant to help entities that serve underserved people provide more affordable drugs and health services. ## Related bills - 119-hr-3151: SHIPS for America Act of 2025 - 119-hr-4669: FEMA Act of 2025 - 119-hr-4317: PBM Reform Act of 2025 - 119-hr-137: TCJA Permanency Act - 119-hr-3633: Digital Asset Market Clarity Act - 119-hr-1262: Mikaela Naylon Give Kids a Chance Act ## Sources - [119-hr-5256 on Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/5256) ## Related - [119-hr-3151: SHIPS for America Act of 2025](https://policyrisk.com/legislation/119-hr-3151) - [119-hr-4669: FEMA Act of 2025](https://policyrisk.com/legislation/119-hr-4669) - [119-hr-4317: PBM Reform Act of 2025](https://policyrisk.com/legislation/119-hr-4317) - [119-hr-137: TCJA Permanency Act](https://policyrisk.com/legislation/119-hr-137) - [119-hr-3633: Digital Asset Market Clarity Act](https://policyrisk.com/legislation/119-hr-3633) - [119-hr-1262: Mikaela Naylon Give Kids a Chance Act](https://policyrisk.com/legislation/119-hr-1262) - [All bills in Congress](https://policyrisk.com/legislation) Source: PRIA, https://policyrisk.com/legislation/119-hr-5256 (as of 2026-04-21).