Oregon Health & Science University leaders say a federal drug discount pilot set to begin next year could create a “significant cash-flow risk” for the institution and undermine its ability to serve low-income patients.

The concern centers on a pilot approved last month by the Trump administration that would test a major change to the long-standing 340B Drug Discount program , which was created in the 1990s to help hospitals and clinics that serve large numbers of low-income, uninsured or Medicaid patients. The program allows those safety-net providers to buy certain outpatient medications at steep discounts — often half the usual price or less — while billing insurers at regular rates. Hospitals say the savings help fund free and reduced-cost care.

Under the new 340B Rebate Model Pil

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