Advocates for Community Health (ACH) sent a letter to HRSA Administrator Thomas Engels urging the agency to preserve and defend the 340B program’s upfront discount model. ACH warned that manufacturer-proposed rebate systems—requiring health centers to pay full price for medications and seek reimbursement later—could disrupt cash flow, require costly operational changes and create significant administrative burdens. The organization also raised concerns about manufacturers seeking claims data and conducting oversight activities beyond their statutory authority. ACH called on HRSA to continue its enforcement efforts and defend the original discount model in court to protect community health centers and the patients they serve.