Eli Lilly moved to withhold 340B discounts from hospitals that did not comply with new paperwork requirements, triggering backlash from hospital groups and appeals for federal oversight. Multiple hospital stakeholders urged the Health Resources and Services Administration (HRSA) to intervene. The dispute centers on Lilly’s interpretation of compliance for the federal 340B program and whether a manufacturer can set additional documentation requirements beyond existing program rules. Hospital groups argue the policy is unlawful and that Lilly lacks legal authority to create its own compliance conditions. The fight signals heightened scrutiny of specialty drug pricing and patient-assistance mechanisms, with potential downstream effects on hospital dispensing economics and patient access—particularly for high-volume 340B-covered medicines.