As Ohio Lawmakers Consider Legislation That Would Expand 340B Loopholes, New Investigation Exposes How Health Centers Are Already Abusing the Program at Patients’ Expense

The Institute for Health Policy Accountability (IHPA), an independent authority on key drivers of decision-making in the health care space, today released a sweeping new report exposing how Ohio’s “non-profit” health centers are suing vulnerable patients for unpaid bills, handing executives outsized compensation packages, and failing federal compliance standards, all while collecting taxpayer-funded benefits through the 340B federal drug discount program. And now, state lawmakers are considering legislation that would give these same health centers even more.

The Ohio Statehouse is currently considering HB 276 / SB198, which would bar drug manufacturers from restricting 340B drug shipments to health centers and contract pharmacies, stripping away existing guardrails and opening the door to even greater abuse of a program designed to serve vulnerable communities. The health centers cheering on this legislation are the same ones this report catches red-handed, pocketing millions in drug markups, and shortchanging low-income patients. 

The Ohio report continues IHPA’s ongoing series revealing how non-profit health centers across the country exploit the 340B program while failing the communities they are meant to serve. The report examines several Ohio non-profit health centers participating in the 340B program: Signature Health, Five Rivers Health Centers, HealthSource of Ohio, Highland Health Providers, Mary Rutan Health, MetroHealth Medical Center, Mount Carmel Health System, Northeast Ohio Neighborhood Health Services, Health Partners of Western Ohio, and Third Street Clinics.

Key findings from the IHPA Ohio report include:

Drug pricing abuse and explosive pharmacy revenue growth

• Health Partners of Western Ohio reported over $30.2 million in 340B pharmacy revenue in 2024, representing more than 40% of its total revenue.
• Five Rivers Health Centers made nearly $23 million in pharmacy revenue while spending just $9 million on medication supply costs, a markup of more than 150%, and a dramatic increase from just $4.6 million in pharmacy revenue in 2020. Five Rivers also spent nearly 3.5% of its expenses on executive compensation in 2024.
• Third Street Clinics saw pharmacy revenue surge from $3.9 million in 2023 to $10.5 million in 2024, while the average markup on prescription drugs nearly doubled.
• Highland Health Providers posted a 270% increase in pharmacy revenue in its first year working with a 340B compliance consultant, with prescription capacity growing 560% and its claims capture rate doubling from 2023 to 2024. 

Suing vulnerable patients and cutting charity care

• Mary Rutan Health sued 2,700 patients over two years for unpaid medical bills. 
• Mount Carmel Health System sued 1,600 patients over two years for unpaid medical bills, despite many being at 100 percent of the poverty level.

Read the full report here.

BACKGROUND ON 340B: 

• The 340B Drug Pricing Program was enacted by Congress in 1992 and meant to lower prescription drug costs for non-profit hospitals that serve low-income and vulnerable communities. Instead, research shows the program has been exploited by major non-profit health systems that generate billions in annual revenue.
• This report follows a Senate HELP Committee hearing in October 2025, where Republican Senators voiced their frustrations with the program.
• According to a CBO analysis late last year, hospitals across the U.S. have exploited the 340B Drug Pricing Program, resulting in significant waste, fraud, and abuse. The report found that the program “encourages behaviors that increase federal spending and raise prices for American taxpayers.”

The Institute for Health Policy Accountability is an independent authority on key drivers of decision making in the health care space. IHPA provides fact-based research and analysis across the public policy landscape, adding a central and currently missing voice to the conversation.

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