340B.  Three numbers and one letter.  What does it mean?  For most Americans, it’s an unknown part of the federal health care bureaucracy. It only shows up for the people it helps every day.

A safety net health care provider is what you might assume it is: It’s a health care entity — such as a community health center, public hospital or clinic — that provides essential services to low-income, uninsured or vulnerable populations, regardless of their ability to pay.

If you live in parts of California, Oregon or Hawaii, you have probably seen or been to a facility that Adventist Health operates. It’s a faith-based, nonprofit integrated health system that runs hospitals and clinics as well as primary and cancer care centers

For years, drug manufacturers have relied on a single U.S. Supreme Court case to fend off lawsuits from safety-net providers: Astra USA, Inc. v. Santa Clara County, decided in 2011.

The 340B Program uses a statutory formula to calculate the maximum price a drug manufacturer can charge a covered entity. For some drugs, that formula produces a ceiling price at or below zero.

The False Claims Act (FCA) is one of the federal government’s most effective tools for recovering money lost to fraud. Originally enacted during the Civil War to combat defense contractor fraud, the FCA has evolved into a broad anti-fraud statute that covers any false or fraudulent claim submitted to the government.

On March 18, 2026, Sagebrush filed a notice of supplemental authority alerting the court to the Adventist decision, which had been issued the day before.