PBM Accountability Project Members React to Minnesota Hospital Association Push for 340B Expansion, While Program Loopholes, Abuse Persist

As the Minnesota Legislature nears the end of the 2026 session, lawmakers are considering HF 3609, a bill that would expand the 340B drug discount program with little to no additional oversight or accountability to help ensure the program is working as intended.

A report released by the Minnesota Department of Health earlier this year found that aspects of the program, particularly contract pharmacy arrangements and the involvement of for-profit intermediaries have evolved into significant commercial enterprises. Critics argue the legislation does not include sufficient safeguards to ensure savings are directly benefiting patients rather than middlemen.  

PBM Accountability Project member and CEO of the Community Liver Alliance, Suzanna Masartis, issued the following statement:

“At a last minute press conference yesterday, the Minnesota Hospital Association attempted to revive legislation protecting contract pharmacy arrangements under the federal 340B program, claiming the bill is necessary to support hospitals. However, limited transparency and inadequate oversight have allowed portions of the 340B program to be exploited by for-profit pharmacy chains and intermediaries that collect substantial revenues originally intended to support safety-net providers and vulnerable patients.

"Because contract pharmacies are not explicitly referenced in the original 340B statute, oversight and accountability have remained inconsistent, and there are currently no federal requirements ensuring that savings are directly passed on to patients. Minnesota’s own transparency report found that covered entities paid approximately $120 million to contract pharmacies. Additionally, 50 cents of every $1 in 340B contract pharmacy revenue goes to just four corporations: CVS Health, Accredo specialty pharmacy, Walgreens and Wal-Mart.

“Legislators should focus on ensuring that for-profit pharmacies and PBM-affiliated entities are not siphoning resources away from safety-net care. HF 3609 risks preserving the status quo without addressing the underlying transparency and accountability concerns. Lawmakers should take additional time to fully evaluate the program and develop policies that ensure patients, not corporate intermediaries benefit from 340B savings.  

"For liver patients who rely on costly specialty medications for chronic liver disease, liver cancer, transplantation, and rare liver conditions, ensuring that 340B savings directly support patient care is not just a policy issue, it is a matter of access, survival, and quality of life. Until Minnesota increases transparency and strengthens oversight of these middlemen, the 340B program will continue to enrich large corporate entities while many patients still struggle to afford their medications.”

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