Program growth outpaced completed oversight reforms
GAO’s latest consolidated 340B testimony says covered-entity sites more than doubled from 2013 through 2023. Yet the Health Resources and Services Administration had fully implemented only five of 20 GAO recommendations reviewed through February 2025.
That leaves 15 recommendations unfinished—a 25% completion rate. The unresolved work includes eligibility oversight, duplicate-discount controls and improvements to audit and removal processes.
| Measure | Finding |
|---|---|
| Covered-entity site growth, 2013–2023 | More than doubled |
| GAO recommendations reviewed | 20 |
| Fully implemented | 5 |
| Not fully implemented | 15 |
| HRSA covered-entity audits | About 200 annually |
Audits cover only a slice of a growing universe
GAO reports that HRSA audits about 200 covered entities each year. The testimony does not convert that number into a universal audit rate, because entities can operate multiple sites and the program universe is organized in more than one way.
HRSA did not concur with six of the 15 unfinished recommendations and concurred with nine but cited statutory-authority limits for some actions. A disagreement over authority is relevant counterevidence; it does not erase the control weakness GAO identified.
What the records establish
The original contribution is the completion calculation and its relationship to program expansion. As the number of participating sites grew, three-quarters of GAO’s selected corrective actions remained unfinished in the latest status set.
The finding does not show that every 340B provider is ineligible, that discounts never benefit patients or that 15 recommendations are equally important. It shows that federal oversight reforms have lagged behind a rapidly expanding program.
Method and limitations
This newsroom counted GAO’s implemented and outstanding recommendations from the consolidated testimony and checked the product page’s publication and release dates. The testimony was published October 23, 2025 and publicly released November 17, 2025; its recommendation-status review runs through February 2025.
The site-growth period ends in 2023, so it is a trend baseline rather than a current-day count. Program participation and recommendation status can change; readers should use GAO’s live recommendation pages for subsequent updates.