HHS and HRSA approved multiple drugmaker proposals to test a 340B rebate model that shifts discounts to post‑dispense rebates rather than upfront discounts, prompting immediate objections from hospital groups. HRSA approved eight manufacturers’ rebate plans and HHS disclosed approvals for major firms including Merck and Bristol Myers Squibb. Hospital associations argue the model increases administrative burdens and cash‑flow strain for providers; HHS and sponsors say the pilot aims to curb fraud and modernize program integrity.