What happenedOn August 7, 2026, Chief Judge Roberto A. Lange of the U.S. District Court for the District of South Dakota granted the state’s motions to dismiss in three consolidated challenges to Senate Bill 154, codified as SDCL chapter 58-29G, Drug Discount Program Protections, at sections 58-29G-1 through 58-29G-4: AbbVie Inc. v. Jackley, No. 3:25-cv-03006-RAL; AstraZeneca Pharmaceuticals LP v. Jackley, No. 4:25-cv-04156-RAL; and Pharmaceutical Research and Manufacturers of America v. Jackley, No. 3:25-cv-03021-RAL (consolidated order of August 7, 2026, filed at the AstraZeneca docket). The court held that “S.B. 154 does not function as a price regulation and is not federally preempted or otherwise unconstitutional or illicit,” following the Eighth Circuit’s decisions in Pharmaceutical Research and Manufacturers of America v. McClain, 95 F.4th 1136 (8th Cir. 2024), and Novartis Pharmaceuticals Corp. v. Hanaway, No. 25-1619 (8th Cir. July 1, 2026), and rejected the takings and dormant Commerce Clause claims. AbbVie filed a notice of appeal to the Eighth Circuit on Monday, August 10; AstraZeneca and PhRMA had not appealed as of that afternoon (South Dakota Searchlight, August 10).

Why it mattersThe Eighth Circuit has now come out the same way twice, in McClain on the merits and in Hanaway on preliminary relief, and a district court in the circuit has applied that reasoning a third time. The opinion states the rule plainly enough to plan around: state shield laws survive because they govern where a manufacturer must deliver, not what the drug costs. That distinction protects contract pharmacy access, which is how many covered entities reach patients beyond their own walls. It also caps what any state statute can do about the rebate mechanism, the discount amount, or payment timing, all of which sit in federal law. As of August 15, 2026, the appeal remains pending.

What happenedGovernor JB Pritzker signed House Bill 2371, the Patient Access to Pharmacy Protection Act, on August 7, 2026; it became Public Act 104-0758 and took effect on signature. AbbVie and Novartis each sued that same day in the U.S. District Court for the Northern District of Illinois, naming Attorney General Kwame Raoul, and Bristol Myers Squibb followed with a third complaint (Legal Newsline, August 11; Capitol Fax, August 11). The Act bars manufacturers from denying, restricting, or interfering with the acquisition or delivery of 340B drugs to covered entities or their contract pharmacies unless federal law requires it. It cleared the Senate 55 to 0 and the House 113 to 1 on concurrence in the Senate amendments. The complaints plead Supremacy Clause preemption and a Fifth Amendment taking, and argue the statute compels manufacturers to transfer product to commercial pharmacies at 340B prices. Pritzker also signed HB 4327, Public Act 104-0769, the 340B Transparency, Reporting, and Accountability Act, directing the Illinois Department of Insurance to study 340B participation by covered entities and manufacturers (Governor’s office, August 7).

Why it mattersVenue and speed are the story. The Eighth Circuit has gone against manufacturers twice on this question and the Fifth Circuit once. The Seventh Circuit has not ruled on a state 340B delivery statute at all. Two complaints arrived the day the Act took effect, before any covered entity had operated under it for a business day, against a statute that cleared the Senate unanimously and lost a single vote in the House. That timing points toward building a circuit conflict rather than remedying a concrete injury. A split is what puts the question in front of the Supreme Court, and a Supreme Court answer would govern every state shield law at once.

What happenedHRSA’s annual 340B recertification window for hospitals opened Monday, August 10, 2026 and closes September 9, 2026 (340B Report, August 13). Hospitals face revised questions on drug shipping addresses and entity-owned pharmacies. The revisions trace to HRSA’s information collection request for enrollment and recertification, OMB No. 0915-0327, submitted for review in the Federal Register on January 8, 2026 and approved by OMB on June 4, 2026. HRSA describes the change as “providing additional clarification for covered entities to complete the shipping address section in 340B OPAIS”; commenting entities described it as “additional clarifying questions identifying wholly owned pharmacies and health care service delivery sites.” The collection also requires STD and TB grantees to supply a copy of the federal grant notice of award, with subgrantees supplying the executed written subrecipient agreement. HRSA estimates total annualized burden at 74,248 hours across roughly 46,183 respondents.

Why it mattersThis is the only item on the week’s list that a hospital controls outright, and the consequence of missing it is removal from the program. The new questions also tell you where HRSA is looking. Asking an entity to identify which shipping addresses belong to wholly owned pharmacies, and to document that ownership, builds the dataset an auditor would need to test entity-owned versus contract pharmacy claims later. Answers you file this month become the baseline for future audits.

What happenedHRSA’s revised 340B Rebate Model Pilot Program notice published at 91 FR 48883 on August 3, 2026. Manufacturers must submit rebate plans no later than August 24, 2026, for participation effective January 1, 2027, covering drugs selected under the Medicare Drug Price Negotiation Program for initial price applicability years 2026 and 2027. Covered entities buy at wholesale acquisition cost, have up to 45 calendar days from dispensing to submit a rebate claim, and manufacturers must pay within 10 calendar days of a complete claim. If a submission comes back incomplete, the 10-day clock restarts when the missing data arrives. HRSA puts the pilot’s scope at less than 5.5 percent of total 340B sales based on 2025 data; the program as a whole covered 15,249 covered entities and 49,214 associated sites as of April 1, 2026. HRSA will act on manufacturer plans by September 24, 2026. Separately, S. 5244, the SUSTAIN 340B Act introduced August 5, 2026 by Senators Boozman, Moran, Baldwin, Capito, Kaine, and Hickenlooper, would end any 340B rebate model within one year of enactment and move HHS to an independent third-party clearinghouse; it sits with the Senate HELP Committee.

Why it mattersTen days is the payment window. The cycle runs much longer. It starts at purchase, when you pay wholesale acquisition cost instead of the ceiling price, extends across a submission window of up to 45 days, and closes only when a complete claim is paid. HRSA argues the gap costs entities little, on the reasoning that the 10-day rule lands ahead of standard wholesaler payment terms. That holds where your wholesaler terms run longer than your full claim cycle and your claims clear on the first pass. Test both assumptions against your own accounts payable rather than accepting them. The scope figure also looks small in aggregate; check it against your own purchase volume in the drugs CMS selected for negotiation. A bill that would end the program within a year does not change the January 1 date, and neither does the litigation over the prior version.

What happenedAbbVie Inc. v. Kennedy, No. 1:26-cv-01190, before Judge Randolph D. Moss in the U.S. District Court for the District of Columbia, continues to brief. AbbVie filed April 8, 2026, arguing HRSA’s reading of “patient” is broader than the 340B statute allows. Proposed intervenors 340B Health and others filed their reply supporting intervention on August 11, 2026, following AbbVie’s August 4 response and NACHC’s August 3 reply. The government’s reply on its motion to dismiss is due August 27, 2026 (Georgetown Health Care Litigation Tracker). In a separate matter, the First Circuit has scheduled oral argument for September 15, 2026 in American Hospital Association v. AbbVie Inc., No. 25-2237, an appeal from the denial of manufacturer intervention in the rebate pilot litigation (Georgetown Health Care Litigation Tracker).

Why it mattersContract pharmacy access decides where a 340B prescription can be filled. The patient definition decides which prescriptions qualify in the first place. A narrower federal definition would shrink the eligible population at every dispensing site, entity-owned and contract alike, in every state, regardless of any shield statute. That makes this the case with the widest reach on the current docket for a DSH hospital. The intervention fight matters for the same reason: the government is the only party now defending the agency’s reading, and it answers to an administration that has already moved twice on 340B rebates.