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SB5981 • 2026
Protecting patient access to discounted medications and health care services through Washington's health care safety net by preventing manufacturer limitations on the 340B drug pricing program.
This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.
Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.
340B drug pricing program
These notes stay tied to the official amendment files and metadata from the legislature.
0 • Health Care & Wellness
Plain English: 5981-S2.E AMH HCW H3663.1 E2SSB 5981 - H COMM AMD By Committee on Health Care & Wellness ADOPTED 03/06/2026 Strike everything after the enacting clause and insert the 1 following: 2 "NEW SECTION.
2432 • Dufault
Plain English: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 5981-S2.E AMH DUFA POOL 278 1 - Official Print By Representative Dufault EFFECT: Removes language regarding numbers of covered entities and manufacturers from the intent section.
2433 • Manjarrez
Plain English: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 5981-S2.E AMH MANJ POOL 279 1 - Official Print By Representative Manjarrez EFFECT: Prohibits a covered entity from entering into a contract with an additional contract pharmacy unless the pharmacy is in a rural county or medically underserved area.
2434 • Engell
Plain English: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 5981-S2.E AMH ENGE POOL 280 1 - Official Print By Representative Engell 5981-S2.E AMH ENGE POOL 280 E2SSB 5981 - H AMD TO HCW COMM AMD (H-3663.1/26) 2434 NOT ADOPTED 03/06/2026 On page 2, beginning on line 26 of the striking amendment, after "entities" strike all material through "manufacturers" on line 27 and insert "and contract pharmacies" On page 2, beginning on line 28 of the striking amendment, strike all of subsection (11) On page 4, line 23 of the striking amendment, after "(O)" insert "that has contracted with an additional contract pharmacy during the fiscal year" On page 6, line 15 of the striking amendment, after "For" strike "manufacturers and" On page 6, beginning on line 16 of the striking amendment, after "act" strike all material through "43.71C.050" on line 17 On page 6, beginning on line 22 of the striking amendment, after "data." strike all material through "covered" on line 23 and insert "Covered" On page 6, beginning on line 26 of the striking amendment, after "(3)" strike all material through "(a)" on line 28 On page 6, beginning on line 29 of the striking amendment, after "revenue" strike all material through "43.71C.100" on page 7, line 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 5981-S2.E AMH ENGE POOL 280 2 - Official Print EFFECT: Removes language regarding manufacturer reporting and filing fees from the intent section.
2435 • Abell
Plain English: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 5981-S2.E AMH ABEL POOL 281 1 - Official Print By Representative Abell 5981-S2.E AMH ABEL POOL 281 E2SSB 5981 - H AMD TO HCW COMM AMD (H-3663.1/26) 2435 NOT ADOPTED 03/06/2026 On page 3, line 7 of the striking amendment, after "(3)" insert ""Low-income patient" means a patient of a covered entity with a family income below 400 percent of the federal poverty guidelines.
2450 • Dufault
Plain English: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 5981-S2.E AMH DUFA POOL 291 1 - Official Print By Representative Dufault EFFECT: Establishes that the legislative privilege does not apply to internal deliberations regarding the act.
2456 • Marshall
Plain English: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 5981-S2.E AMH MARS POOL 290 1 - Official Print By Representative Marshall EFFECT: Establishes that the effective date of the act is contingent on the final adjudication or dismissal of all claims in the following cases, including any appeals: (1) Pharmaceutical Research & Manufacturers of America v.
2457 • Marshall
Plain English: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 5981-S2.E AMH MARS POOL 288 1 - Official Print By Representative Marshall EFFECT: Requires covered entities to use at least 50 percent of revenues from the federal 340B Drug Pricing Program to decrease the costs of 340B drugs that are dispensed or administered to patients.
2467 • Stokesbary
Plain English: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 5981-S2.E AMH STOK POOL 292 1 - Official Print By Representative Stokesbary EFFECT: Establishes that the prohibitions on manufacturer restrictions regarding delivery and acquisition of 340B drugs do not apply to a hospital belonging to a state governmental entity, where the hospital employees of a nonprofit corporation wholly controlled by that entity were wrongly not enrolled in the public employees’ retirement system between January 1, 2010, and January 1, 2020.
2468 • Marshall
Plain English: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 5981-S2.E AMH MARS POOL 282 1 - Official Print By Representative Marshall 5981-S2.E AMH MARS POOL 282 E2SSB 5981 - H AMD TO HCW COMM AMD (H-3663.1/26) 2468 NOT ADOPTED 03/06/2026 On page 3, line 7 of the striking amendment, after "(3)" insert ""Direct patient care" means the provision of medical services, dental services, pharmaceutical services, or behavioral health services directly administered to individual patients being treated for, or suspected of having, medical or behavioral health conditions.
2469 • Marshall
Plain English: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 5981-S2.E AMH MARS POOL 283 1 - Official Print By Representative Marshall EFFECT: Prohibits a covered entity from receiving a discount through the federal 340B Drug Pricing Program and Medicaid for the same drug.
2479 • Marshall
Plain English: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 5981-S2.E AMH MARS POOL 287 1 - Official Print By Representative Marshall EFFECT: Prohibits a covered entity from requesting a discount under the federal 340B Drug Pricing Program for a drug dispensed or administered to an enrollee in a health plan offered to public employees if doing so would result in the health plan losing access to a manufacturer rebate available for the same drug.
2480 • Marshall
Plain English: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 5981-S2.E AMH MARS POOL 286 1 - Official Print By Representative Marshall EFFECT: Requires a non-profit hospital covered entity to verify that profits from the federal 340B Drug Pricing Program are used in ways that are distinct from community benefit activities identified in the hospital's annual tax filings.
2481 • Marshall
Plain English: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 5981-S2.E AMH MARS POOL 285 1 - Official Print By Representative Marshall EFFECT: Prohibits covered entities from contracting with pharmacies that are owned by or affiliated with a pharmacy benefit manager.
2482 • Marshall
Plain English: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 5981-S2.E AMH MARS POOL 284 1 - Official Print By Representative Marshall EFFECT: Requires a hospital covered entity to provide a level of charity care that exceeds the national average level of charity care provided by hospitals that are not covered entities.
2483 • Marshall
Plain English: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 5981-S2.E AMH MARS POOL 277 1 - Official Print By Representative Marshall 5981-S2.E AMH MARS POOL 277 E2SSB 5981 - H AMD TO HCW COMM AMD (H-3663.1/26) 2483 NOT ADOPTED 03/06/2026 On page 3, after line 29 of the striking amendment, insert the following: "NEW SECTION.
2484 • Marshall
Plain English: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 5981-S2.E AMH MARS POOL 289 1 - Official Print By Representative Marshall 5981-S2.E AMH MARS POOL 289 E2SSB 5981 - H AMD TO HCW COMM AMD (H-3663.1/26) 2484 NOT ADOPTED 03/06/2026 On page 7, after line 14 of the striking amendment, insert the following: "NEW SECTION.
2485 • Marshall
Plain English: 5981-S2.E AMH MARS H3797.1 E2SSB 5981 - H AMD TO HCW COMM AMD (H-3663.1/26) 2485 By Representative Marshall NOT ADOPTED 03/06/2026 Beginning on page 1, line 3, strike all material through "RCW." 1 on page 12, line 37 and insert the following: 2 "NEW SECTION.
654 • Cleveland
Plain English: 5981-S2 AMS CLEV S5097.3 2SSB 5981 - S AMD 654 By Senator Cleveland ADOPTED 02/13/2026 Strike everything after the enacting clause and insert the 1 following: 2 "NEW SECTION.
670 • Muzzall
Plain English: 5981-S2 AMS MUZZ S5158.1 2SSB 5981 - S AMD TO S AMD (S-5097.3/26) 670 By Senator Muzzall NOT ADOPTED 02/13/2026 On page 3, after line 20, insert the following:1 "(3) Pursuant to 42 U.S.C.
671 • Muzzall
Plain English: 5981-S2 AMS MUZZ S5157.1 2SSB 5981 - S AMD TO S AMD (S-5097.3/26) 671 By Senator Muzzall NOT ADOPTED 02/13/2026 On page 3, beginning on line 21, after " (1)" strike all material 1 through "(2)" on line 30 2 Renumber the remaining subsection consecutively and correct any 3 internal references accordingly.
672 • Short
Plain English: 5981-S2 AMS SHOR S5159.1 2SSB 5981 - S AMD TO S AMD (S-5097.3/26) 672 By Senator Short NOT ADOPTED 02/13/2026 On page 3, after line 20, insert the following:1 "(3) A covered entity may not contract with a pharmacy to receive 2 and dispense a 340B drug on behalf of the covered entity if that 3 pharmacy is owned by or affiliated with a pharmacy benefit manager, 4 as defined in RCW 48.200.020." 5 EFFECT: Prohibits covered entities from contracting with pharmacies that are owned by or affiliated with a pharmacy benefit manager.
2nd substitute bill substituted.
340B drug pricing program
AN ACT Relating to protecting patient access to discounted 1 medications and health care services through Washington's health care 2 safety net by preventing manufacturer limitations on the 340B drug 3 pricing program; adding a new chapter to Title 69 RCW; and 4 prescribing penalties. 5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:6 NEW SECTION. Sec. 1. (1) The legislature finds that the federal 7 340B drug pricing program is essential for providing health care 8 access to low-income and uninsured populations. The 340B drug pricing 9 program requires drug manufacturers to offer discounts on outpatient 10 medications to eligible providers that serve these populations. They 11 include federally qualified health centers, Ryan White (HIV) clinics, 12 tribal and urban Indian health centers, critical access hospitals, 13 and other safety net hospitals that meet stringent federal criteria.14 (2) Congress created the 340B drug pricing program in 1992, 15 stating that the program's benefits enable covered "entities to 16 stretch scarce federal resources as far as possible, reaching more 17 eligible patients and providing more comprehensive services." (H.R. 18 Rep. No. 102-384 (II), at 12 (1992)). The 340B drug pricing program 19 allows certain safety net providers to sustain underfunded services 20 and reinvest savings into essential community benefits, such as 21 S-3542.1 SENATE BILL 5981 State of Washington 69th Legislature 2026 Regular Session By Senators Cleveland, Slatter, Harris, Bateman, Alvarado, Chapman, Dhingra, Frame, Hasegawa, Liias, Pedersen, Saldaña, and Valdez Prefiled 01/05/26. Read first time 01/12/26. Referred to Committee on Health & Long-Term Care. p. 1 SB 5981 financial assistance for low-income patients, no-cost wellness 1 visits, screenings, vaccinations, transportation to appointments, 2 health education classes, case management, medication adherence 3 services, and workforce development programs. 4 (3) The federal health resources and services administration 5 permits 340B covered entities to contract with pharmacies to enable 6 access to life-saving drugs and drugs that preserve quality of life 7 to eligible patients, including for those who otherwise have limited 8 access. 9 (4) The 340B drug pricing program and contract pharmacies are 10 crucial to Washington's safety net providers by ensuring patients can 11 access their prescribed medications, while providing additional 12 resources to 340B covered entities to serve vulnerable and 13 underserved populations. 14 (5) More than 20 other states have recognized the importance of 15 contract pharmacies to the 340B drug pricing program and have taken 16 action to prohibit drug manufacturers from imposing restrictions on 17 340B covered entities' ability to serve patients through contract 18 pharmacies. 19 (6) Federal courts, including the fifth and eighth circuit courts 20 of appeals, have upheld states' authority to legislate on the 21 distribution of 340B drugs through contract pharmacies.22 (7) The current restrictions imposed by drug manufacturers not 23 only limit a patient's access to affordable medication but also 24 jeopardize the financial savings that safety net providers depend on 25 to reinvest in their operations, expand services, and support 26 underserved communities. 27 (8) The legislature, therefore, finds that prohibiting drug 28 manufacturers from imposing restrictions on 340B covered entities is 29 necessary to protect Washington's vulnerable patients, their access 30 to medications, and safety net providers' ability to serve their 31 patients. 32 NEW SECTION. Sec. 2. The definitions in this section apply 33 throughout this chapter unless the context clearly requires 34 otherwise.35 (1) "340B drug" means a drug that has been subject to an offer 36 for reduced prices by a manufacturer under 42 U.S.C. Sec. 256b and is 37 purchased by a covered entity. 38 p. 2 SB 5981 (2) "Covered entity" means an entity authorized to participate in 1 the federal 340B drug pricing program, as defined in 42 U.S.C. Sec. 2 256b(a)(4) as of the effective date of this section.3 (3) "Manufacturer" means a person, corporation, or other entity 4 engaged in the manufacture of drugs or devices. It includes an agent, 5 contractor, or affiliate of a manufacturer. 6 (4) "Package" has the same meaning as in 21 U.S.C. Sec. 7 360eee(11)(A) as of the effective date of this section.8 (5) "Pharmacy" has the same meaning as in RCW 18.64.011.9 (6) "Third-party logistics provider" has the same meaning as in 10 21 U.S.C. Sec. 360eee(22) as of the effective date of this section.11 NEW SECTION. Sec. 3. (1) A manufacturer or a distributor or 12 third-party logistics provider of a manufacturer's drugs may not, 13 directly or indirectly, deny, restrict, or prohibit the acquisition 14 of a 340B drug by, or delivery of a 340B drug to, a covered entity, a 15 pharmacy that is under contract with a covered entity to receive and 16 dispense a 340B drug on behalf of the covered entity, or any location 17 authorized by a covered entity to receive such 340B drug, unless 18 federal law prohibits receipt of the 340B drug.19 (2) A manufacturer or a distributor or third-party logistics 20 provider of a manufacturer's drugs may not, directly or indirectly, 21 require a covered entity to submit any claims, utilization, 22 purchasing, or other data as a condition for allowing the acquisition 23 of a 340B drug by, or delivery of a 340B drug to, a covered entity, a 24 pharmacy that is under contract with a covered entity to receive and 25 dispense a 340B drug on behalf of the covered entity, or any location 26 authorized by a covered entity to receive such 340B drug, unless 27 federal law requires such data sharing. 28 NEW SECTION. Sec. 4. (1) In addition to any other remedy 29 provided by law, a covered entity may file a civil action against a 30 manufacturer, distributor, or third-party logistics provider for a 31 violation of this chapter. If a court finds that the manufacturer, 32 distributor, or third-party logistics provider violated this chapter, 33 the court may enjoin the violation and award a civil penalty of up to 34 $5,000 per day for each violation, as well as reasonable attorneys' 35 fees and costs. Each package of 340B drugs subject to a prohibited 36 act under this chapter constitutes a separate violation.37 p. 3 SB 5981 (2) The attorney general may bring an action in the name of the 1 state, or as parens patriae on behalf of persons residing in the 2 state, to enforce this chapter. For actions brought by the attorney 3 general to enforce the provisions of this chapter, the legislature 4 finds that the practices covered by this chapter are matters vitally 5 affecting the public interest for the purpose of applying the 6 consumer protection act, chapter 19.86 RCW. For actions brought by 7 the attorney general to enforce this chapter, a violation of this 8 chapter is not reasonable in relation to the development and 9 preservation of business and is an unfair or deceptive act in trade 10 or commerce and an unfair method of competition for the purpose of 11 applying the consumer protection act, chapter 19.86 RCW.12 (3) Nothing in this chapter is to be construed or applied to 13 conflict with federal law and related regulations, including 21 14 U.S.C. Sec. 355-1, or other laws of this state, if the state law is 15 compatible with applicable federal law. 16 NEW SECTION. Sec. 5. If any provision of this act or its 17 application to any person or circumstance is held invalid, the 18 remainder of the act or the application of the provision to other 19 persons or circumstances is not affected.20 NEW SECTION. Sec. 6. Sections 1 through 4 of this act 21 constitute a new chapter in Title 69 RCW.22 --- END --- p. 4 SB 5981