This bill aims to ensure that federally-qualified health centers receive upfront discounted pricing for covered outpatient drugs under the 340B program. It prohibits agreements that would require these centers to pay more than the ceiling price for drugs at the point of purchase. The bill clarifies that no arrangements should allow the payment of excess amounts at the time of purchase with later reconciliation through rebate or other payment. The effective date for these amendments is the enactment date, applying to drugs purchased afterward and will also be considered for existing agreements.