A US appeals court has denied the Trump administration's request to continue a pilot program that would change the way drugs are reimbursed under the federal 340B rebate program.[3][6] In doing so, it upheld an earlier ruling by the Maine District Court that had suspended the program as a preliminary injunction.[3][6] The pilot program was supposed to start on January 1 and allow several pharmaceutical companies to provide discounts in the form of rebates after the drug is issued, instead of the previous discounts when purchasing.[3][6] According to the court, the federal agency Health Resources and Services Administration (HRSA) did not sufficiently consider the consequences for the so-called safety-net hospitals and clinics that rely on rebates from the 340B program.[3][4][6] The lawsuit was filed by the American Hospital Association and several hospital systems, which claimed that the government hastily implemented the program and violated the Administrative Procedure Act.[3][6] The program covered high-priced drugs, including those already covered by 340B, and required hospitals to pay full price first, with the discount returned to them later in the form of a rebate.[3][6]