Vermont is making headlines as one of the first states to pass comprehensive 340B legislation that combines contract pharmacy protections with new compliance requirements—and a controversial pricing policy.
On May 30, the Vermont legislature passed H.266, a bill that would ban manufacturer restrictions on contract pharmacies, require hospitals to submit annual 340B program reports, and introduce pricing caps on certain outpatient drugs. The bill now heads to Governor Phil Scott’s desk.
Key Provisions of H.266
1. Contract Pharmacy Protections
H.266 would prohibit drug manufacturers from restricting 340B contract pharmacy arrangements within the state. This provision would take effect January 31, 2026, securing access for covered entities that rely on third-party pharmacy partners.
2. Annual Hospital Reporting
Hospitals participating in 340B would be required to submit detailed annual reports outlining how the program is being used, its financial impact, and operational data. This aligns with a growing national trend toward greater transparency and accountability in 340B.
3. Outpatient Drug Price Caps
Beginning January 1, 2026, the bill would cap the price of hospital-administered outpatient drugs at 120% of the average sales price (ASP). Critical access hospitals and facilities not affiliated with a hospital network would be exempt.
Hospitals may request waivers if they can demonstrate that the cap is negatively impacting patient access or rural care sustainability.
UVM Health Network Pushes Back
Not everyone supports the bill in its current form. The University of Vermont Health Network, which operates the state’s only academic medical center, has voiced strong opposition to the pricing provision.
What Comes Next?
Governor Phil Scott has five days to sign or veto the bill once it’s formally delivered. If signed, the reporting and pricing provisions will become law in 2026, giving covered entities time to prepare for operational changes and financial impacts.
Why This Matters
Vermont’s H.266 is a clear example of how state-level 340B policy is evolving. As contract pharmacy access continues to face manufacturer-imposed barriers, states are responding with legislative action—often bundled with transparency requirements and, increasingly, pricing oversight.
RxTrail will continue to monitor the outcome of H.266 and provide guidance on how covered entities can adapt to changing compliance and reporting expectations.
