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AMERICAN HOSPITAL ASSN. v. BECERRA 

Opinion of the Court 

under option 2 that it could do under option 1—including 
varying the reimbursement rates by hospital group.  So un-
der HHS’s interpretation, the agency would never need to 
conduct a survey of hospitals’ acquisition costs.  But why, 
then, would Congress have constructed this elaborate stat-
ute  premised  on  HHS’s  surveys  of  hospitals’  acquisition
costs,  including  specifying  when  HHS  could  vary  reim-
bursement rates by hospital group?  HHS has no good an-
swer to that question.

HHS’s  interpretation  not  only  would  render  irrelevant 
the survey prerequisite for varying reimbursement rates by
hospital group, but also would render largely irrelevant the
provision of the statute that precisely details the require-
ments  for  surveys  of  hospitals’  acquisition  costs.    See 
§1395l(t)(14)(D).  We must hesitate to adopt an interpreta-
tion  that  would  eviscerate  such  significant  aspects  of  the 
statutory text.  See, e.g., Chicago v. Fulton, 592 U. S. ___, 
___ (2021) (slip op., at 5); Maine Community Health Options 
v. United States, 590 U. S. ___, ___ (2020) (slip op., at 16); 
Whitman v. American Trucking Assns., Inc., 531 U. S. 457, 
484−485 (2001).

In  short,  the  statute  allows  HHS  to  set  reimbursement 
rates based on average price and affords the agency discre-
tion to “adjust” the price up or down.  But unless HHS con-
ducts a survey of hospitals’ acquisition costs, HHS may not 
vary the reimbursement rates by hospital group. 

As a final argument, HHS insists that Congress could not 
have  intended  for  the  agency  to  “overpay”  340B  hospitals 
for prescription drugs.  But when enacting this statute in 
2003,  Congress  was  well  aware  that  340B  hospitals  paid 
less for covered prescription drugs.  After all, that had been 
the law for the duration of the 340B program, which began
in  1992.  In  2003,  Congress  nonetheless  did  not  see  fit  to
differentiate 340B hospitals from other hospitals when re-
quiring that the reimbursement rates be uniform under op-
tion 2.  And for more than a decade after this statute took