Which States Protect Your Contract Pharmacy Arrangements — and Which Don't
Last Updated: July 2026 | Sources: NACHC State Tracker, 340B Report, America’s Essential Hospitals, HRSA
Why This Guide Exists
Since 2020, pharmaceutical manufacturers have increasingly restricted 340B covered entities from accessing discounted drug pricing through contract pharmacies — limiting the number of contract pharmacies per entity, imposing geographic restrictions, and requiring detailed claims data submissions as conditions of access.
In response, states have fought back. The first two states to enact contract pharmacy access laws were Arkansas in 2021 and Louisiana in 2023, followed by Maryland, Kansas, Minnesota, Mississippi, Missouri, and West Virginia in 2024. In 2025, 13 more states enacted 340B contract pharmacy access laws. Washington became the 22nd state to enact a contract pharmacy access law when Governor Bob Ferguson signed S.B. 5981 on March 25, 2026.
Visit the Website Mintz ►
But the legal landscape is shifting constantly. Manufacturers are suing states in federal courts. Some state laws are being upheld. Others face injunctions. And the federal government itself has in some cases taken the manufacturers’ side.
This guide gives you the clearest possible picture of where your state stands right now — and what it means for your contract pharmacy arrangements.
⚠️ Important: This guide is for educational purposes and is updated quarterly. The 340B legal landscape changes rapidly. Always verify your state’s current status with a qualified 340B compliance consultant or your state pharmacy association before making program decisions.
THE BIG PICTURE
Two Types of State Protection
There are two distinct types of state laws protecting 340B program participants — and your state may have one, both, or neither:
Type 1 — Contract Pharmacy Access Laws
These laws prohibit pharmaceutical manufacturers from restricting or denying 340B discounted pricing to covered entities that use contract pharmacies. This is the most important protection for your 340B program — without it, manufacturers can legally limit how many contract pharmacies you use, or require claims data as a condition of access.
Type 2 — PBM Non-Discrimination Laws
These laws prohibit pharmacy benefit managers (PBMs) and health plans from reimbursing 340B pharmacies at lower rates than non-340B pharmacies, or from excluding 340B pharmacies from their networks. Approximately 30 states have passed legislation aimed at prohibiting discriminatory reimbursement tactics by PBMs. Frier Levitt
Many states have both. Some have only one. And some have neither.
THE STATE-BY-STATE TABLE
✅ States With Contract Pharmacy Access Laws — 22 States as of July 2026
These states prohibit manufacturers from restricting 340B contract pharmacy access.
ARKANSAS
Status: ✅ Protected — Law in Effect
Law: SB 167, enacted 2021 — the first state in the nation to pass a contract pharmacy access law
What it does: Prohibits pharmaceutical manufacturers from denying 340B drug pricing for Arkansas-based contract pharmacies. Also prohibits manufacturers from restricting the number of contract pharmacies a covered entity may use.
Legal status: Upheld. The U.S. 8th Circuit Court of Appeals upheld Arkansas’ law against a constitutional challenge from PhRMA — a landmark ruling that sparked the wave of state legislation that followed.
Reporting requirement: No
Risk level for contract pharmacies: 🟢 Low
HAWAII
Status: ✅ Protected — Law in Effect, Under Legal Challenge
Law: Contract pharmacy access law enacted 2025
What it does: Prohibits manufacturers from restricting 340B contract pharmacy arrangements in the state.
Legal status: A Hawaii federal judge denied AstraZeneca’s bid to block enforcement of the state’s 340B contract pharmacy access law. PhRMA and AbbVie also filed suit — appeals court ruling pending.
Reporting requirement: No
Risk level for contract pharmacies: 🟡 Medium (litigation ongoing) Visit the WebSite 340B Report ►
IDAHO
Status: ✅ Protected — Law in Effect
Law: Contract pharmacy access law enacted 2025
What it does: Prohibits manufacturers from restricting 340B contract pharmacy access.
Legal status: No active manufacturer lawsuits reported as of July 2026.
Reporting requirement: Yes — covered entities must report program data
Risk level for contract pharmacies: 🟢 Low
LOUISIANA
Status: ✅ Protected — Law in Effect, Upheld on Appeal
Law: Contract pharmacy access law enacted 2023
What it does: Prohibits manufacturers from restricting 340B pricing at contract pharmacies in Louisiana.
Legal status: In a victory for covered entities, the Fifth Circuit upheld Louisiana’s 340B contract pharmacy protection law.
Reporting requirement: No
Risk level for contract pharmacies: 🟢 Low Visit the WebSite RWC-340B ►
MAINE
Status: ✅ Protected — Law in Effect
Law: Contract pharmacy access law enacted 2025; also PBM non-discrimination law
What it does: Prohibits manufacturers from restricting contract pharmacy access. Also prohibits PBMs from reimbursing 340B entities at lower rates than non-340B entities.
Legal status: A federal court in Maine denied PhRMA’s request to halt enforcement of the law.
Reporting requirement: Yes — one of the first states to impose provider reporting requirements
Risk level for contract pharmacies: 🟢 Lower.
MINNESOTA
Status: ✅ Protected — Law in Effect
Law: Contract pharmacy access law enacted 2024
What it does: Prohibits manufacturers from restricting 340B contract pharmacy access. Minnesota was also one of the first three states to impose mandatory reporting requirements on covered entities.
Legal status: The Minnesota Court of Appeals held that Minnesota may enforce its 340B contract pharmacy access law against drug manufacturers, reversing an earlier lower court ruling.
Reporting requirement: Yes — mandatory annual reporting for covered entities
Risk level for contract pharmacies: 🟢 Low Visit the WebSite Kodiaksolutions ►
MISSISSIPPI
Status: ✅ Protected — Law in Effect, Upheld on Appeal
Law: Contract pharmacy access law enacted 2024
What it does: Prohibits manufacturers from restricting 340B pricing at contract pharmacies.
Legal status: A federal appeals court unanimously upheld Mississippi’s 340B contract pharmacy access law against an AbbVie challenge.
Reporting requirement: No
Risk level for contract pharmacies: 🟢 Low 340B Report
MISSOURI
Status: ✅ Protected — Law in Effect
Law: Contract pharmacy access law enacted 2024
What it does: Prohibits manufacturers from restricting 340B contract pharmacy access.
Legal status: No active manufacturer lawsuits blocking enforcement as of July 2026.
Reporting requirement: No
Risk level for contract pharmacies: 🟢 Low
NEBRASKA
Status: ✅ Protected — Law in Effect, Under Legal Challenge
Law: Contract pharmacy access law enacted 2025
What it does: Prohibits manufacturers from restricting 340B contract pharmacy arrangements.
Legal status: In June 2025, AstraZeneca filed a federal lawsuit against Nebraska Attorney General Michael Hilgers seeking to block the state’s newly enacted contract pharmacy access law. The law remains in effect while litigation is pending.
Reporting requirement: No
Risk level for contract pharmacies: 🟡 Medium (litigation ongoing) Visit the WebSite Mintz ►
NEW MEXICO
Status: ✅ Protected — Law in Effect, Complex Manufacturer Situation
Law: Contract pharmacy access law enacted 2025
What it does: Prohibits manufacturers from restricting 340B contract pharmacy access.
Legal status: AbbVie filed a second lawsuit challenging New Mexico’s health center 340B contract pharmacy access law. Meanwhile, some manufacturers have individually exempted — and then removed exemptions for — New Mexico providers. Monitor manufacturer-specific policies closely.
Reporting requirement: No
Risk level for contract pharmacies: 🟡 Medium Visit the WebSite 340B Report ►
NORTH DAKOTA
Status: ✅ Protected — Law in Effect, Under Legal Challenge
Law: Contract pharmacy access law enacted 2025
What it does: Prohibits manufacturers from restricting 340B contract pharmacy access.
Legal status: Manufacturer challenges pending in district court as of July 2026.
Reporting requirement: No
Risk level for contract pharmacies: 🟡 Medium (litigation pending)
OKLAHOMA
Status: ✅ Protected — Law in Effect
Law: Contract pharmacy access law enacted 2025
What it does: Prohibits manufacturers from restricting 340B contract pharmacy arrangements.
Legal status: No active injunctions blocking enforcement as of July 2026.
Reporting requirement: No
Risk level for contract pharmacies: 🟢 Low
OREGON
Status: ✅ Protected — Law in Effect, Under Legal Challenge
Law: Contract pharmacy access law enacted 2025; also PBM non-discrimination law
What it does: Prohibits manufacturers from restricting 340B contract pharmacy access. Also prohibits discriminatory PBM reimbursement.
Legal status: Manufacturer challenges pending in district court. Note: Amgen exempted Oregon from its contract pharmacy restrictions following the law’s enactment — but manufacturer-specific policies can change.
Reporting requirement: No
Risk level for contract pharmacies: 🟡 Medium
RHODE ISLAND
Status: ✅ Protected — Law in Effect
Law: Contract pharmacy access law enacted 2025/2026; also PBM non-discrimination law (Senate Bill 114)
What it does: Rhode Island’s Senate Bill 114 expressly prohibits insurers, PBMs, manufacturers, and other third-party payors from reimbursing 340B drugs at rates lower than those for non-340B drugs or from placing different terms, conditions, fees, or restrictions based solely on participation in the 340B program.
Reporting requirement: Yes — covered entities must describe program oversight activities
Risk level for contract pharmacies: 🟢 Low Visit the WebSite Frier Levitt ►
SOUTH DAKOTA
Status: ✅ Protected — Law in Effect
Law: Contract pharmacy access law enacted 2025
What it does: Prohibits manufacturers from restricting 340B contract pharmacy access.
Legal status: No active manufacturer lawsuits blocking enforcement as of July 2026.
Reporting requirement: No
Risk level for contract pharmacies: 🟢 Low
TENNESSEE
Status: ✅ Protected — Law in Effect, Upheld in Court
Law: Contract pharmacy access law enacted 2025
What it does: Prohibits manufacturers from restricting 340B contract pharmacy arrangements. Specifically, the court affirmed that the state’s prohibition on manufacturers requiring claims data not mandated under federal law is consistent with federal statute.
Legal status: A federal judge dismissed both AbbVie’s and PhRMA’s separate lawsuits challenging Tennessee’s contract pharmacy law within a three-week span.
Reporting requirement: No
Risk level for contract pharmacies: 🟢 Low Visit the WebSite ACI340B Management ►
UTAH
Status: ✅ Protected — Law in Effect, Under Legal Challenge
Law: Contract pharmacy access law enacted 2025
What it does: Prohibits manufacturers from restricting 340B contract pharmacy access.
Legal status: The first drugmaker sued Utah’s contract pharmacy access law in 2025. Litigation is ongoing.
Reporting requirement: No
Risk level for contract pharmacies: 🟡 Medium
VERMONT
Status: ✅ Protected — Law in Effect, Under Legal Challenge
Law: Contract pharmacy access law enacted 2025; also covered entity reporting requirements
What it does: Prohibits manufacturers from restricting 340B contract pharmacy access.
Legal status: PhRMA filed suit in Vermont in 2025. Appeals court ruling pending.
Reporting requirement: Yes — covered entities must describe program oversight activities
Risk level for contract pharmacies: 🟡 Medium
WASHINGTON
Status: ✅ Protected — Law in Effect (Most Recent), Under Legal Challenge
Law: S.B. 5981, signed March 25, 2026 — the 22nd state law and the first enacted in 2026
What it does: Washington became the first state to pair contract pharmacy protections with mandatory reporting requirements for both providers and manufacturers. The law took effect June 10, 2026.
Legal status: AbbVie and Novartis filed suit the same day the law was signed. Litigation ongoing — the law is currently in effect.
Reporting requirement: Yes — mandatory for both providers and manufacturers
Risk level for contract pharmacies: 🟡 Medium (very new law, active litigation) Visit the WebSite ACI340B Management ►
WEST VIRGINIA
Status: ⚠️ Protected by Law — But Enforcement Blocked
Law: Contract pharmacy access law enacted 2024
What it does: Prohibits manufacturers from restricting 340B contract pharmacy access.
Legal status: In December 2024, a federal court issued a preliminary injunction in favor of PhRMA and Novartis, prohibiting West Virginia from enforcing its pharmacy access law. The 4th Circuit Court of Appeals sided with manufacturers in the West Virginia case. As of July 2026, this law is NOT currently enforceable.
Risk level for contract pharmacies: 🔴 High — law not currently enforceable Visit the WebSite Mintz340B Report ►
⚠️ States With PBM Non-Discrimination Laws Only
These states protect against discriminatory PBM reimbursement but do NOT have manufacturer contract pharmacy access laws.
ALABAMA — PBM non-discrimination law enacted 2021. Prohibits PBMs from excluding 340B pharmacies from networks or reimbursing them at lower rates. No manufacturer contract pharmacy access law.
CONNECTICUT — PBM non-discrimination law. After January 1, 2024, contracts between a Connecticut 340B covered entity and a PBM may not include discriminatory reimbursement terms based on 340B status. No manufacturer contract pharmacy access law.
FLORIDA — PBM non-discrimination protections. State lawmakers introduced provider-backed 340B bills in 2026 — status pending. No enacted manufacturer contract pharmacy access law as of July 2026.
KENTUCKY — PBM non-discrimination provisions. No manufacturer contract pharmacy access law.
MICHIGAN — Legislature adjourned in 2024 before passing a pharmacy access bill that had strong momentum. No enacted manufacturer contract pharmacy access law as of July 2026.
NEW YORK — The Senate Finance Committee unanimously advanced S. 1913, the “340B Prescription Drug Anti-Discrimination Act.” Full Senate floor vote pending. No enacted law yet.
Approximately 30 states have some form of PBM non-discrimination protection. Check your state pharmacy association for the specific provisions applicable in your state.
❌ States With No Contract Pharmacy Protection Laws
These states have neither a contract pharmacy access law nor meaningful PBM non-discrimination protections for 340B entities.
The following states have introduced legislation but had not enacted contract pharmacy access laws as of July 2026. Covered entities in these states are most vulnerable to manufacturer restrictions:
CALIFORNIA — No enacted contract pharmacy access law. Largest 340B market in the US. Bills have been introduced but not enacted.
GEORGIA — No enacted contract pharmacy access law.
ILLINOIS — No enacted contract pharmacy access law as of July 2026.
INDIANA — Has enacted 340B covered entity reporting requirements — but without accompanying contract pharmacy protections. Covered entities in Indiana complain that the reporting law increases administrative burdens while failing to ensure the sustainability of the 340B program through contract pharmacy protections. Additionally, Indiana has moved to end 340B savings under Medicaid, which providers warn would be devastating. Visit the WebSite RWC-340B ►
KANSAS — Has a contract pharmacy access law, but it expires June 30, 2026 and the legislature failed to pass a renewal bill before adjournment. As of July 2026 the status of Kansas’ contract pharmacy protections is uncertain — consult your state pharmacy association immediately.
OHIO — Has mandatory covered entity reporting requirements — but no contract pharmacy access law. The reporting requirements are among the most onerous in the country.
PENNSYLVANIA — No enacted contract pharmacy access law.
TEXAS — No enacted contract pharmacy access law. Federal appeals court proceedings involving Texas DSH hospitals are ongoing on unrelated issues.
VIRGINIA — Governor Glenn Youngkin vetoed contract pharmacy protection legislation. No enacted law as of July 2026.
For all states not listed in the protection section above, assume manufacturer restrictions on contract pharmacy access may be in effect. Contact the 340B Prime Vendor Program at 1-888-340-2787 for current guidance.
SPECIAL SECTION: MANUFACTURER-BY-MANUFACTURER RESTRICTIONS
Even in states with contract pharmacy access laws, some manufacturers are imposing data submission requirements, exempting certain states, or revising their policies. Here is what you need to know:
Eli Lilly — Effective February 1, 2026, Lilly requires covered entities to submit claim-level data for pharmacy dispenses and medical claims for all Lilly products to the 340B ESP platform within 45 days. Covered entities in Colorado, Maine, Nebraska, North Dakota, Oregon, Rhode Island, South Dakota, Tennessee, Vermont, and West Virginia, as well as FQHCs in New Mexico, are currently exempt from this requirement. Kodiaksolutions
Novo Nordisk — Effective April 1, 2026, all covered entity types must submit claim-level detail for in-house pharmacy dispenses and medical claims for Novo Nordisk products to the 340B ESP platform within 45 days. Failure to provide complete and accurate data may result in suspension of 340B pricing access. Visit the WebSite Kodiaksolutions ►
AbbVie — Has filed lawsuits against multiple states including Tennessee (dismissed), New Mexico, Nebraska, and Washington. Has exempted certain states from restrictions where favorable legal decisions exist.
AstraZeneca — Has filed lawsuits in Colorado, Hawaii, Nebraska, and Oregon. Has also dropped lawsuits in some states following favorable legal outcomes.
Amgen — Revised its contract pharmacy policy to exempt Oregon following the state’s enactment of a contract pharmacy access law, while simultaneously removing its prior exemption for New Mexico providers.
GSK — Has exempted Maine and Oregon from 340B contract pharmacy restrictions.
BMS (Bristol Myers Squibb) — Effective May 1, 2026, requires covered entities to submit claim-level data for all 340B utilization of certain covered outpatient drugs to the 340B ESP platform within 45 days.
⚠️ Manufacturer policies change frequently and often with little notice. Monitor the 340B ESP platform, manufacturer websites, and the 340B Report’s Contract Pharmacy Restrictions Tracker at 340breport.com for current manufacturer-specific policies.
WHAT THIS MEANS FOR YOUR CONTRACT PHARMACY
If you’re in a state WITH a contract pharmacy access law:
Your state prohibits manufacturers from restricting your covered entity’s access to 340B pricing at contract pharmacies. However, legal challenges are ongoing in many states — the law being on the books does not guarantee it will be enforceable if a court issues an injunction. Monitor your state’s litigation status quarterly and have a contingency plan if your law is temporarily blocked.
If you’re in a state WITHOUT a contract pharmacy access law:
Manufacturers may legally restrict your access to 340B pricing at contract pharmacies. Common restrictions include limiting you to one contract pharmacy per covered entity, requiring claims data as a condition of access, or requiring contract pharmacies to be within a geographic radius. Work with the 340B Prime Vendor Program and a qualified compliance consultant to understand which manufacturers are restricting access in your state and what your options are.
Regardless of your state’s law:
Manufacturer data submission requirements (like those from Lilly, Novo Nordisk, and BMS) apply in many states regardless of contract pharmacy access laws. Make sure your covered entity is enrolled in the 340B ESP platform and is submitting data as required to avoid losing access to 340B pricing.
KEY RESOURCES FOR STAYING CURRENT
340B Report Contract Pharmacy Restrictions Tracker
340breport.com/trackers (subscription required for full access)
NACHC State-Level 340B Laws Tracker
Updated quarterly at nachc.org — free download
America’s Essential Hospitals 340B State Snapshot
essentialhospitals.org
340B Prime Vendor Program
340bpvp.com | 1-888-340-2787 | apexusanswers@340bpvp.com
HRSA Office of Pharmacy Affairs
hrsa.gov/opa
ASHP State 340B Resources
ashp.org/pharmacy-practice/340b
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This guide is provided for general educational purposes by 340bprogram.com, a resource published by Medication Packaging Solutions. It is based on publicly available information from NACHC, the 340B Report, America’s Essential Hospitals, and other sources as of July 2026. State laws and their enforcement status change frequently. This guide does not constitute legal or compliance advice. Verify your state’s current status with a qualified 340B compliance consultant, your state pharmacy association, or the 340B Prime Vendor Program at 1-888-340-2787 before making any program decisions.
Page updated: July 2026.