340B Rebate Pilot: Preparing for HRSA’s 2026 Pilot

This shift created by the 340B Rebate Pilot creates new risks for cash flow, compliance, and patient care. At The Craneware Group, we’re helping 340B-eligible organizations anticipate the impact now — so you’re ready when the pilot begins.

Preparation isn’t optional. It’s essential to maintaining 340B compliance and protecting access for patients who rely on this program. Explore our quick-hit resources to get ready for the rebate pilot.

A New Era for 340B: What the Rebate Pilot Means for Covered Entities 

HRSA’s rebate pilot is the most significant change to the 340B Program in decades. Covered entities will need to:  

  • Pay more up front, straining budgets and patient services 
  • Wait longer for reimbursement through rebate submissions 
  • Manage new documentation requirements and manufacturer interactions 

The Risks Ahead: Denials, Delays, and Financial Strain 

Our analysis of real-world provider data revealed the scale of the challenge: 

  • $700M in upfront costs advanced to manufacturers in year one, based on a representative sample of covered entities 
  • Increased risk of payor-style denials and delays 
  • Hidden compliance and documentation gaps that could jeopardize rebates 

The Craneware Group’s Provider-First Approach 

As the leader in healthcare revenue cycle management and 340B program compliance, The Craneware Group partners only with providers — never manufacturers. 

  • Neutrality matters: we advocate exclusively for covered entities 
  • Decades of experience: defending revenue against denials and compliance pressure 
  • Proven results: trusted by top U.S. hospitals to safeguard scarce resources 

When disruption hits, you need a partner who prioritizes your mission, not manufacturer interests.  

Steady Support Through Transition and Beyond 

When the rebate model takes effect, you don’t have to face the risks alone. The Craneware Group is ready to help providers: 

  • Protect operating cash flow during rebate recovery delays 
  • Use data and documentation to defend against denials 
  • Navigate evolving requirements with compliance-first technology 

Your mission is patient care. Ours is ensuring financial sustainability so you can keep care accessible. 

Our Advocacy: The Craneware Group’s Response to HRSA 

The Craneware Group submitted a formal response to HRSA on behalf of covered entities, urging for: 

  • More time to implement requirements 
  • Greater clarity on manufacturer interfaces 
  • Stronger protections against abuse and denials 

[Read our full HRSA comment letter]