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Federal Advocacy: HAP Calls for Support for Rural Health, 340B Hospitals

August 01, 2023

In a pair of new advocacy letters, HAP called on federal lawmakers to support rural health care and hospitals in the 340B program.

The letters come as House and Senate leaders are focusing on several important legislative and regulatory proposals affecting hospitals and health systems. Here’s what you need to know:

Rural health priorities in the Farm Bill

Last week, HAP President and CEO Nicole Stallings urged lawmakers in the House Agriculture Committee to consider ways to support rural health care and rural hospitals in the new Farm Bill.

“Access to quality health care is critical to maintaining strong, rural Pennsylvania communities,” the letter said. “Hospitals play a vital role in providing that care. In addition, hospitals help build economically healthy communities. Rural hospitals are top job providers and support the economies of their communities, but many need financial support.”

The letter highlighted several important priorities to include in the new Farm Bill:

  • A funding increase for the Community Facilities Direct Loan and Grant Program
  • The reauthorization of $90 million for the Distance Learning and Telemedicine Grant Program
  • Increased funding for the Gus Schumacher Nutrition Incentive Program: Produce Prescription Program

“Access to health care is at risk in rural areas, the letter said. “Hospitals in these communities not only make that care possible but improve local economies. Thank you for considering these policy priorities for inclusion in the Farm Bill.”

The letter is available online.


In a comment letter to U.S. Senators, HAP outlined the benefits of the 340B program and ways to strengthen the program to serve Pennsylvania’s most vulnerable populations. The 340B program helps hospitals that care for uninsured and low-income patients to manage the impact of high-cost drugs by purchasing discounted medications from drug manufacturers.

About 45 percent of the commonwealth’s hospitals participate in the 340B program, with about half in urban areas, and half in rural areas. “Many 340B hospitals are the lifelines of their community, and the discounts they receive through the 340B program enable these organizations to care for patients,” the comment letter notes. “However, these facilities are financially vulnerable.”

The Health Resources and Services Administration can support the program by:

  • Finalizing the administrative dispute resolution process to outline which 340B entities can address wrongful restrictions and underpayments imposed by drug manufacturers.
  • Codifying protections for contract pharmacy arrangements in the federal 340B statute.
  • Prohibiting pharmacy benefit managers from implementing policies that provide differential reimbursement to 340B providers, those that steer patients away from 340B pharmacies, and those that require patients to procure medications prior to a needed procedure.
  • Increasing oversight of drug manufacturers’ pricing practices and overt and unlawful attempts to shrink the 340B program.

The letter is available online.

For more information about HAP’s federal advocacy, contact John Myers, vice president, federal advocacy.